Sulfate deficiency is seen in children with autism through increased urinary excretion of sulfate and low plasma sulfate levels. Potential factors impacting reduced sulfation include phenosulfotransferase activity, sulfate availability, and the presence of the gut toxin p-cresol. Epsom salt baths, vitamin supplementation, and fecal microbiota transplant therapy are all potential treatments with promising results. Sulfate levels have potential for use as a diagnostic biomarker, allowing for earlier diagnosis and intervention.