MRI-guided focused ultrasound (MRgFUS) thalamotomy has expanded the surgical treatment envelope for patients with essential tremor who fail on first-line pharmacological therapies. Understanding differences in access to MRgFUS thalamotomy, a procedure publicly funded in Ontario, is a first step to ensuring equitable opportunity for treatment across the province. In this brief communication, we explore the frequency of referrals directed to our tremor program between 2018 and 2023. We highlight differences in referral rates by jurisdiction and medical specialty, and explore associations with socio-economic factors. Our findings inform public policy and identify geographical areas for targeted outreach to enhance equitable access.