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Substantial geographic disparities in melanoma incidence and access to tanning bed facilities exist. In this spatial ecological study, we evaluate the relationship between access to tanning bed facilities and melanoma incidence. New England county-level melanoma incidence rates (2014-2018), tanning bed facilities location, demographic data, socioeconomic data, and geographic data were obtained from the National Cancer Institute State Cancer Profiles, Data Axle, American Community Survey, and United States Geological Survey. Spatial regression models were utilized to determine the association between melanoma incidence and access to tanning beds, adjusting for confounding factors. Adjusted spatial regression identified that for every 1-minute increase in average travel time to tanning facilities within 30 minutes travel time threshold, the melanoma incidence rate decreased by 3.46% in the same county and by 1.92% across New England. We found a negative association between average travel time to tanning facilities and county-level melanoma incidence rate, suggesting that policy aimed at decreasing access to indoor tanning facilities has the potential to reduce melanoma rates. High-risk clusters, with respect to county-level melanoma rate, were also identified. Targeting of interventions and resources to high-risk clusters may reduce geographic melanoma rates disparities., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)