Child care programs (including Head Start, prekindergarten [pre-K], and other center-based care) can differ, with patterns of use based on their location. Yet little research has examined how Head Start and pre-K programs affect children's academic school readiness, including vocabulary and reading skills at school entry, in the South as compared to other regions. To examine this further, secondary data (n = 2,803) collected in the Fragile Families and Child Well-Being Study were examined. Overall findings suggest, regardless of region, that Head Start and pre-K participants had higher academic skills at school entry than did their counterparts. In addition, when Head Start was compared to other center-based care and pre-K was compared to other care arrangements, both had larger effects on improving academic skills in the South compared with in other regions. These findings imply that Head Start and pre-K programs should target children who otherwise would receive nonparental non-center-based care. Future research should focus on why the effects of Head Start and pre-K vary between the South and other regions.