The advent of advanced biomolecular technologies for detecting molecular and genomic signatures of individual tumors has transformed oncology care, introducing proven methodologies that can inform treatment with matched targeted therapies and predict response at the individual patient level. However, access to these technologies has been hampered by multiple barriers, most notably price and obtainability. Other barriers include lack of knowledge of available technologies, concerns about value, and outdated infrastructures that impede critical operations within the clinic or laboratory. Accessibility barriers to advanced biomolecular testing are critically important to patient care, as new technological advances in molecular medicine continue to outpace the implementation of solutions. Given the proven evidence for improved patient outcomes with precision oncology medicines, it is imperative to understand the value afforded by these technologies. The purpose of this narrative review is to describe existing and emerging barriers to access and present a "roadmap to access" that will facilitate the urgently needed discussions to identify solutions for improving access. Implementation of these solutions will raise awareness of available technologies and treatments and their prognostic significance, improve evidence collection for demonstration of value, and fortify clinical and laboratory infrastructure and operations.