South Dakota • MEDICAL CARD GUIDE
How to Get Your South Dakota Medical Marijuana Card
A voter-created program that grew into 81 dispensaries and roughly 19,800 patients, with no delivery and no adult-use fallback.
South Dakota voters approved medical cannabis in 2020 and the program has been running long enough to feel settled. Eighty-one licensed dispensaries served roughly 19,800 patients as of August 2026. The card is the only lawful route in this state, because the adult-use measure passed at the same election was struck down and nothing has replaced it.
Quick Facts
Qualifying Conditions
South Dakota pairs a list of named conditions with a symptom pathway, which is how most patients qualify.
- Cancer
- AIDS or HIV positive status
- Amyotrophic lateral sclerosis
- Crohn disease
- Epilepsy and seizure disorders
- Glaucoma
- Multiple sclerosis
- Post-traumatic stress disorder
- A chronic or debilitating condition producing cachexia or wasting syndrome
- A chronic or debilitating condition producing severe, debilitating pain
- A chronic or debilitating condition producing severe nausea
- A chronic or debilitating condition producing seizures
- A chronic or debilitating condition producing severe and persistent muscle spasms
Severe debilitating pain is the pathway most South Dakota patients use. The practitioner certifies both the underlying condition and the symptom, so bring records that establish duration and impact rather than a single visit.
Finding a Certifying Practitioner
South Dakota had 211 certifying practitioners as of August 2026, which is a workable number but not a large one for a state this size.
Your own practitioner
Standard office visit rateThe cheapest route where they participate. Your chart already documents the condition and symptom the certification depends on.
Certification clinics
Roughly 100 to 200 dollarsPractices around Sioux Falls and Rapid City that handle certifications regularly and know the registry process.
Telemedicine
Varies by serviceUseful given the distances involved in western South Dakota. Confirm the practitioner is licensed in South Dakota and participates in the program.
Tip: Ask about cultivation at the certification visit. South Dakota allows registered patients to grow with practitioner authorization, and it is easier to include from the start than to add later.
The Application Process
South Dakota runs an online registry through the Department of Health, following a practitioner certification.
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Confirm residency and a qualifying condition
You need a South Dakota driver license or state ID and a condition on the list, or a condition producing one of the listed symptoms.
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Get certified
A participating South Dakota practitioner completes the written certification, in person or by telemedicine.
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Apply through the state registry
Submit the application with your certification, identification and photo. Caregivers register separately and undergo a background check.
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Pay the state fee
South Dakota charges a registration fee with a reduced rate available for qualifying applicants. The practitioner visit is billed separately.
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Buy in person
Present your card and photo ID at any of the 81 licensed dispensaries. Delivery is not permitted, so the purchase happens at the counter.
Costs and Fees
A moderately priced program with a reduced rate worth asking about.
- State registration A set fee, reduced for qualifying applicants
- Practitioner certification Office rate, or 100 to 200 dollars at a clinic
- Caregiver registration Separate application and background check
- Annual renewal Fresh certification plus the registration fee
- Dispensary products Retail pricing plus applicable sales tax
Total Estimate: 150 to 300 dollars for the first year
After You Are Approved
The card is the only lawful route in South Dakota, so these limits define your access completely.
- Purchase at any of the 81 licensed dispensaries with your card and photo ID
- Possess up to 3 ounces of cannabis as a registered patient
- Home cultivation where your practitioner authorizes it, with plant counts set by state law
- A registered caregiver may purchase and transport on your behalf
- Access to flower, edibles, vapes, tinctures, concentrates and topicals
- No delivery. Every purchase is collected in person
- No adult-use market to fall back on if your registration lapses
Renewal
South Dakota cards run one year and renewal means a fresh certification plus another application. Because there is no adult-use market here, a lapsed registration leaves you with no lawful source at all. That is a sharper consequence than in Montana or Minnesota, where an expired card simply costs you a better tax rate.
Timeline: Start 45 days out. With 211 participating practitioners statewide, appointment availability is the usual constraint.
Frequently Asked Questions
How many dispensaries are there?
Eighty-one licensed dispensaries as of August 2026, including several operating on tribal land under separate authority.
Is delivery available?
No. South Dakota does not permit dispensary delivery. Purchases are made in person by the patient or a registered caregiver.
How much can I possess?
Up to three ounces of cannabis as a registered patient, with additional rules for cultivated plants where your practitioner authorizes growing.
Can I grow my own?
Yes, where your practitioner authorizes it. Raise it at the certification visit rather than afterwards, because it forms part of the certification.
What happened to adult-use legalization?
Amendment A passed in 2020 and was struck down by the state supreme court. Later measures did not succeed, so the medical program remains the only lawful route.
Is delta-8 legal here?
No. HB 1125 bans delta-8, delta-10, HHC and similar converted cannabinoids in South Dakota.
Do out-of-state patients get access?
South Dakota statute contains provisions for non-resident patients, but practice varies. Confirm the current position with the dispensary before relying on it.
Will a card protect my job?
Not reliably. South Dakota employers can maintain drug-free workplace policies, and registration does not require an employer to accommodate cannabis use.
More South Dakota guides
The South Dakota cannabis guide covers legal status, licensed retail by city, and neighborhood-level pages for this state.
