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Food insecurity spiked in some U.S. regions during the COVID-19 pandemic, as did food access challenges. Concerns were raised that these food issues were more prominent in food deserts, or neighborhoods lacking access to a grocery store or supermarket. Using data collected from a representative sample of Los Angeles County adults between April and October 2020, this study examined relationships between self-reported food insecurity, perceived food access barriers, and residing in a food desert, and examined differences across key geographic regions of the county. There was little relationship between residing in a food desert and experiencing food insecurity. However, perceived grocery store closures/limited hours and not having access to a vehicle were commonly reported barriers to food access, which were associated with more food insecurity. These findings suggest that geographic disparities in food access impact food insecurity. Efforts to address food insecurity should center on achieving food justice and addressing disparities across geographic regions.