OBJECTIVES: The illicit production of methamphetamine from the precursor chemical pseudoephedrine (PSE) in clandestine laboratories fuels a significant portion of the domestic methamphetamine supply.  Although states and the federal government have taken steps to control access to PSE, it continues to be available as a non-prescription drug in all but two states.  The purpose of this project was to assess the relationship between PSE sales and indicators of methamphetamine supply, specifically the number of clandestine laboratory incidents reported, in Kentucky. METHODS: We calculate regression models predicting clandestine methamphetamine lab incidents using 2010 county level Kentucky data.  Explanatory factors include PSE sales (in grams), methamphetamine-related hospitalizations, USDA urban/rural indicator, methamphetamine related arrest, controlled substance (CS) prescriptions dispensed, and population.  Data sources include the Kentucky All Schedule Prescription Electronic Reporting Program, the Kentucky Inpatient Discharge Data Set, the Kentucky State Policy Crime in Kentucky Report, and Clandestine Laboratory Surveillance System. RESULTS: Results indicate a strong relationship between PSE sales and clandestine labs (p<.001). Population has a negative relationship to labs, with larger counties less likely to have clandestine labs (P<.002). Methamphetamine related hospitalizations have a positive relationship to labs (P <.001).  Methamphetamine related arrests have a negative relationship to labs (P < .05).  CONCLUSIONS: PSE sales have a strong relationship to clandestine labs, with greater sales of PSE leading to a greater number of clandestine labs.  Our findings have important policy implications as states struggle with policy options to reduce methamphetamine abuse.  Tighter restrictions on PSE may be justified as a means to reduce clandestine methamphetamine labs.