Background: Children with special healthcare needs (CSHCN) tend to miss more school because of illness. Medical homes are a model of primary health care that coordinate services to better meet the needs of the child. The purpose of this study was to examine the association between presence of medical home and missed school days among CSHCN. Methods: A secondary analysis of cross-sectional data from the 2005 National Survey of Children With Special Healthcare Needs (NS-CSHCN) was conducted. Multivariate ordinal logistic regression was done to analyze the relationship between presence of a medical home and number of missed school days. Results: The presence of a medical home among CSHCN was associated with being in the highest category of missed school days. The adjusted odds ratios for the number of missed school days, after adjustment for poverty, metropolitan statistical area status, education in the household, age, race and ethnicity, demonstrated that access to a medical home does not decrease school absences. Conclusion: Although the data did not support the hypothesis that CSHCN with a medical home would have fewer missed school days due to illness, this study does evoke future research questions, such as what is the relationship between parental perception of child health status with number of missed school days and how adequate is the communication between families and healthcare providers in the medical home. (Contains 2 tables.)