Each year, millions of people purchase snacks and beverages at highway rest areas. These venues are a potential food source for commuters and could be a convenient way to access healthier food compared to common highway options like fast food. To our knowledge, there is no research which has systematically examined the healthiness of food offerings at rest areas. Determine the healthiness of food and beverages offered at rest areas in North Carolina. This was a cross-sectional audit of all rest areas offering foods and beverages in North Carolina in Summer 2018. Research staff identified all rest areas using a state directory, and then drove to each of the Rest Area (n = 30) to collect data. The Nutrition Environment Measures Survey-Vending (NEMS-V) was used to record: vending machine location, all foods and beverages (type, price, size), item location, and healthiness of items offered (based on NEMS-V categorization). Overall healthiness grades and variability by site location. Two researchers independently double coded all vending machine surveys, and consensus was reached. Geospatial analysis using GIS examined proximity to food stores. Analysis included univariate and bivariate analysis. Most vending machines (88%) had less than 30% healthy food or 55% healthy beverage choices, though healthy items were available at each site. There was variability between sites, but no significant differences in the percentage of healthy items between urban and rural areas (P =.32). There was an average of 8.5 fast food restaurants within 5 miles of rest areas, with nearly half of rest areas (47%) being isolated with no fast food nearby. There is a need for policy changes to increase the number and presentation of healthy food options at rest areas. This approach may position rest areas as an alternative to less healthy options for travelers. None. [ABSTRACT FROM AUTHOR]