Black caregivers of autistic children encounter numerous barriers to accessing diagnoses and services, leading to adverse outcomes due to delayed diagnosis and limited access to services. The presence of stigma within the Black community, combined with interpersonal and institutional racism, may contribute to these ongoing inequalities; however, few studies address these forms of discrimination together. This study is based on 55 in-depth interviews conducted with caregivers of Black autistic children receiving services at a public autism clinic in the U.S. South. Using grounded theory analysis of the interview data, our study examines intersectional stigma through ideological, economic, and political lenses to understand how racism and stigma intersect within persistent structural inequities across various social contexts, including punitive community responses toward child behaviors, safety concerns related to public transportation, and challenges in accessing public school services. Our findings highlight the unique difficulties faced by Black caregivers of autistic children, showing how different types of stigma, racism, and structural inequities lead to adverse outcomes such as reluctance to seek help, delayed diagnoses, and limited access to autism services. This study centers on the complex milieu of intersectional stigma, which is an essential step toward understanding the autism experience within low-income and under-resourced Black communities.