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An early adopter of public preschool (i.e., pre-kindergarten, “pre-k”), evidence from Baltimore City, Maryland, can provide insight for those working to improve access to early education opportunities. We followed a cohort of children entering kindergarten in Baltimore City Public Schools during the 2007–2008 year through the 2010–2011 academic year. Students were grouped by pre-k experience: public pre-k (
n
= 2828), Head Start (
n
= 839), Head Start plus public pre-k (
n
= 247), private pre-k (
n
= 993), or informal care (
n
= 975). After adjusting for individual- and school-level characteristics, students from the Head Start plus public pre-k group were the most likely to enter kindergarten with the foundational skills and behaviors needed to be successful (vs. all groups,
P
≤ .001). Students in informal care were the least likely to enter kindergarten with this skillset (vs. all pre-k groups
P
≤ .001). Children from informal care were also significantly more likely than all other groups to be chronically absent in kindergarten (
P
≤ .001). By third grade, children from informal care were least likely to be reading on grade level and most likely to have been retained a grade (vs. all pre-k groups
P
≤ .001). Children from disadvantaged populations who were not enrolled in pre-k faced significant difficulties keeping up with their peers throughout elementary school; interventions to improve their transition to school and increase their likelihood of academic success are warranted. Universal preschool is likely to improve education outcomes for children in urban areas.