In this brief, authors Jess Carson and Sarah Boege describe changes in the early childhood education and care landscape of Grafton and Sullivan Counties in New Hampshire and Orange and Windsor Counties in Vermont, collectively known as the Upper Valley. The authors find that the Upper Valley lost 25 regulated child care providers serving children under age 5 between 2017 and 2021. However, with closure rates twice as high among family-based providers than among center-based providers and some new providers opening, the net number of slots has remained relatively stable (5,169 slots in 2021). The overall effect has been to consolidate available care into fewer, larger settings across the region. Three-quarters of Upper Valley providers open in 2017 were still open in 2021, reflecting greater stability than in non-Upper Valley portions of New Hampshire (71 percent) or Vermont (65 percent). However, the authors caution that early childhood educator workforce shortages limit the ability of child care providers to remain fully operational. They conclude by noting that workforce-supporting policy proposals differ in intensity across states, building on a stronger foundation of investments in Vermont than in New Hampshire. [This brief is part of the "Early Childhood in the Upper Valley Series."]