diff --git a/docs/content/components/guide-card.mdx b/docs/content/components/guide-card.mdx
index 4c04040ed..3ed40e488 100644
--- a/docs/content/components/guide-card.mdx
+++ b/docs/content/components/guide-card.mdx
@@ -81,10 +81,10 @@ variations:
         <div class="nci-guide-card">
           <div class="nci-guide-card__wrapper">
             <div class="nci-guide-card__body">
-              <h2 class="nci-guide-card__title">
+              <h2 class="nci-guide-card__title" id="guide-card-label">
                 Research Grant Funding
               </h2>
-              <ul class="nci-card__button-group">
+              <ul class="nci-card__button-group" aria-labelledby="guide-card-label">
                 <li>
                   <a
                     href="#!"
@@ -229,10 +229,10 @@ code_snippets:
         <div class="nci-guide-card">
           <div class="nci-guide-card__wrapper">
             <div class="nci-guide-card__body">
-              <h2 class="nci-guide-card__title">
+              <h2 class="nci-guide-card__title" id="guide-card-label">
                 Research Grant Funding
               </h2>
-              <ul class="nci-card__button-group">
+              <ul class="nci-card__button-group" aria-labelledby="guide-card-label">
                 <li>
                   <a
                     href="#!"
diff --git a/docs/content/templates/guide-card-row.mdx b/docs/content/templates/guide-card-row.mdx
index 762eb2c4a..906718735 100644
--- a/docs/content/templates/guide-card-row.mdx
+++ b/docs/content/templates/guide-card-row.mdx
@@ -59,7 +59,7 @@ Refer to [Guide Card](/components/guide-card) for best practice recommendations
 
 ```html
 <div class="nci-title-aligned-card-group">
-	<h2 class="nci-guide-card__header">
+	<h2 class="nci-guide-card__header" id="guide-card-caregivers">
 		Patients and Caregivers, with a Title Long Enough to Wrap to a Second Line
 	</h2>
 	<div class="nci-guide-card nci-guide-card--with-image-and-description">
@@ -73,7 +73,10 @@ Refer to [Guide Card](/components/guide-card) for best practice recommendations
 					with information about causes and risk factors, early detection and
 					diagnosis, and treatment options.
 				</p>
-				<ul class="nci-card__button-group">
+				<ul
+					class="nci-card__button-group"
+					aria-labelledby="guide-card-caregivers"
+				>
 					<li>
 						<a
 							href="#!"
@@ -120,7 +123,9 @@ Refer to [Guide Card](/components/guide-card) for best practice recommendations
 			</div>
 		</div>
 	</div>
-	<h2 class="nci-guide-card__header">Researchers</h2>
+	<h2 class="nci-guide-card__header" id="guide-card-researchers">
+		Researchers
+	</h2>
 	<div class="nci-guide-card nci-guide-card--with-image-and-description">
 		<div class="nci-guide-card__wrapper">
 			<picture class="nci-guide-card__image">
@@ -132,7 +137,10 @@ Refer to [Guide Card](/components/guide-card) for best practice recommendations
 					supports the best scientists and research projects through a rigorous
 					grant application and peer review process.
 				</p>
-				<ul class="nci-card__button-group">
+				<ul
+					class="nci-card__button-group"
+					aria-labelledby="guide-card-researchers"
+				>
 					<li>
 						<a
 							href="#!"
@@ -180,8 +188,13 @@ Refer to [Guide Card](/components/guide-card) for best practice recommendations
 		<li class="nci-guide-card desktop:grid-col-4">
 			<div class="nci-guide-card__wrapper">
 				<div class="nci-guide-card__body">
-					<h2 class="nci-guide-card__title">Research Grant Funding</h2>
-					<ul class="nci-card__button-group">
+					<h2 class="nci-guide-card__title" id="guide-card-research">
+						Research Grant Funding
+					</h2>
+					<ul
+						class="nci-card__button-group"
+						aria-labelledby="guide-card-researchers"
+					>
 						<li>
 							<a
 								href="#!"
@@ -232,8 +245,13 @@ Refer to [Guide Card](/components/guide-card) for best practice recommendations
 		<li class="nci-guide-card desktop:grid-col-4">
 			<div class="nci-guide-card__wrapper">
 				<div class="nci-guide-card__body">
-					<h2 class="nci-guide-card__title">Grants Process</h2>
-					<ul class="nci-card__button-group">
+					<h2 class="nci-guide-card__title" id="guide-card-grants">
+						Grants Process
+					</h2>
+					<ul
+						class="nci-card__button-group"
+						aria-labelledby="guide-card-grants"
+					>
 						<li>
 							<a
 								href="#!"
@@ -256,8 +274,13 @@ Refer to [Guide Card](/components/guide-card) for best practice recommendations
 		<li class="nci-guide-card desktop:grid-col-4">
 			<div class="nci-guide-card__wrapper">
 				<div class="nci-guide-card__body">
-					<h2 class="nci-guide-card__title">Funding for Training</h2>
-					<ul class="nci-card__button-group">
+					<h2 class="nci-guide-card__title" id="guide-card-funding">
+						Funding for Training
+					</h2>
+					<ul
+						class="nci-card__button-group"
+						aria-labelledby="guide-card-funding"
+					>
 						<li>
 							<a
 								href="#!"
diff --git a/packages/ncids-twig/components/nci-guide-card/nci-guide-card-group.twig b/packages/ncids-twig/components/nci-guide-card/nci-guide-card-group.twig
index d143ea8f4..a1c9d6eea 100644
--- a/packages/ncids-twig/components/nci-guide-card/nci-guide-card-group.twig
+++ b/packages/ncids-twig/components/nci-guide-card/nci-guide-card-group.twig
@@ -6,8 +6,8 @@
 				<li class="nci-guide-card desktop:grid-col-4">
 					<div class="nci-guide-card__wrapper">
 						<div class="nci-guide-card__body">
-							<h2 class="nci-guide-card__title">{{ card.title }}</h2>
-							<ul class="nci-card__button-group">
+							<h2 class="nci-guide-card__title" id={{ card.cardId }}>{{ card.title }}</h2>
+							<ul class="nci-card__button-group" aria-labelledby={{ card.cardId }}>
 								{% for item in card.buttongroup %}
 									<li>
 										<a href="{{ item.url }}" class="usa-button usa-button--outline usa-button--secondary">
diff --git a/packages/ncids-twig/components/nci-guide-card/nci-guide-card-tile-aligned.twig b/packages/ncids-twig/components/nci-guide-card/nci-guide-card-tile-aligned.twig
index a6770f5c3..04a334cb6 100644
--- a/packages/ncids-twig/components/nci-guide-card/nci-guide-card-tile-aligned.twig
+++ b/packages/ncids-twig/components/nci-guide-card/nci-guide-card-tile-aligned.twig
@@ -2,7 +2,7 @@
 	<div class="grid-container">
 		<div class="nci-title-aligned-card-group">
             {% for card in cards %}
-                <h2 class="nci-guide-card__header">
+                <h2 class="nci-guide-card__header" {% if card.header %}id={{ card.cardId }}{% endif %}>
                     {{ card.header }}
                 </h2>
                 <div class="nci-guide-card {{ card.modifier }}">
@@ -22,7 +22,7 @@
                                 {% if card.description %}
                                     <p class="nci-guide-card__description">{{ card.description }}</p>
                                 {% endif %}
-                            <ul class="nci-card__button-group">
+                            <ul class="nci-card__button-group" aria-labelledby={{ card.cardId }}>
                                 {% for item in card.buttongroup %}
                                     <li>
                                         <a href="{{ item.url }}" class="usa-button usa-button--outline usa-button--secondary">
diff --git a/packages/ncids-twig/components/nci-guide-card/nci-guide-card.twig b/packages/ncids-twig/components/nci-guide-card/nci-guide-card.twig
index 28f3a84b5..18cb67ee7 100644
--- a/packages/ncids-twig/components/nci-guide-card/nci-guide-card.twig
+++ b/packages/ncids-twig/components/nci-guide-card/nci-guide-card.twig
@@ -9,14 +9,14 @@
                     />
                 </picture>
             {% endif %}
-                <div class="nci-guide-card__body">
+                <div class="nci-guide-card__body" >
                     {% if title %}
-                        <h2 class="nci-guide-card__title">{{ title }}</h2>
+                        <h2 class="nci-guide-card__title" id={{ cardId }}>{{ title }}</h2>
                     {% endif %}
                     {% if description %}
                         <p class="nci-guide-card__description">{{ description }}</p>
                     {% endif %}
-                <ul class="nci-card__button-group">
+                <ul class="nci-card__button-group" {% if title %}aria-labelledby={{ cardId }}{% endif %}>
                     {% for item in buttongroup %}
                         <li>
                             <a href="{{ item.url }}" class="usa-button usa-button--outline usa-button--secondary">
diff --git a/testing/ncids-css-testing/stories/components/nci-guide-card/nci-guide-card.default.stories.jsx b/testing/ncids-css-testing/stories/components/nci-guide-card/nci-guide-card.default.stories.jsx
index ab043ca73..d58e7bd90 100644
--- a/testing/ncids-css-testing/stories/components/nci-guide-card/nci-guide-card.default.stories.jsx
+++ b/testing/ncids-css-testing/stories/components/nci-guide-card/nci-guide-card.default.stories.jsx
@@ -16,6 +16,7 @@ export const Default = () => (
 		css={css}
 		html={Template.bind({})({
 			title: 'Research Grant Funding',
+			cardId: 'default-card',
 			'modifier': 'desktop:grid-col-4',
 			'buttongroup': [
 				{
@@ -49,6 +50,7 @@ export const CardGroup = () => (
 			'cards': [
 				{
 					'title': 'Research Grant Funding',
+					cardId: 'card-group-research-funding',
 					'buttongroup': [
 						{
 							'title': 'Funding Opportunities',
@@ -70,6 +72,7 @@ export const CardGroup = () => (
 				},
 				{
 					'title': 'Grants Process',
+					cardId: 'card-group-grants-process',
 					'buttongroup': [
 						{
 							'title': 'Apply for a Grant',
@@ -91,6 +94,7 @@ export const CardGroup = () => (
 				},
 				{
 					'title': 'Funding for Training',
+					cardId: 'card-group-training',
 					'buttongroup': [
 						{
 							'title': 'Funding for Cancer Training',
diff --git a/testing/ncids-css-testing/stories/components/nci-guide-card/nci-guide-card.test-cases.stories.jsx b/testing/ncids-css-testing/stories/components/nci-guide-card/nci-guide-card.test-cases.stories.jsx
index adf1072e6..4dc1c1e6f 100644
--- a/testing/ncids-css-testing/stories/components/nci-guide-card/nci-guide-card.test-cases.stories.jsx
+++ b/testing/ncids-css-testing/stories/components/nci-guide-card/nci-guide-card.test-cases.stories.jsx
@@ -83,6 +83,7 @@ export const TitleAlignedCardGroupWithoutDescription = () => (
 					'image': img_placeholder_16x9,
 					'altText': 'Patients and Caregivers',
 					'modifier': 'nci-guide-card--with-image-and-description',
+					'cardId': 'guide-card-patients-caregivers',
 					'buttongroup': [
 						{
 							'title': 'Funding Opportunities',
@@ -107,6 +108,7 @@ export const TitleAlignedCardGroupWithoutDescription = () => (
 					'image': img_placeholder_16x9,
 					'altText': 'Researchers',
 					'modifier': 'nci-guide-card--with-image-and-description',
+					'cardId': 'guide-card-researchers',
 					'buttongroup': [
 						{
 							'title': 'Apply for a Grand',
@@ -139,6 +141,7 @@ export const TitleAlignedCardGroupWithoutImage = () => (
 				{
 					'header': 'Patients and Caregivers, with a Title Long Enough to Wrap to a Second Line',
 					'modifier': 'nci-guide-card--with-image-and-description',
+					'cardId': 'guide-card-patients-caregivers',
 					'description': 'NCI is the nation&apos;s trusted source for cancer information. We&apos;re here with information about causes and risk factors, early detection and diagnosis, and treatment options.',
 					'buttongroup': [
 						{
@@ -162,6 +165,7 @@ export const TitleAlignedCardGroupWithoutImage = () => (
 				{
 					'header': 'Researchers',
 					'modifier': 'nci-guide-card--with-image-and-description',
+					'cardId': 'guide-card-patients-Researchers',
 					'description': 'Support for the best science underpins everything NCI does. NCI supports the best scientists and research projects through a rigorous grant application and peer review process.',
 					'buttongroup': [
 						{
diff --git a/testing/ncids-css-testing/stories/components/nci-guide-card/nci-guide-card.variants.stories.jsx b/testing/ncids-css-testing/stories/components/nci-guide-card/nci-guide-card.variants.stories.jsx
index 8588ee6c4..83ccec36a 100644
--- a/testing/ncids-css-testing/stories/components/nci-guide-card/nci-guide-card.variants.stories.jsx
+++ b/testing/ncids-css-testing/stories/components/nci-guide-card/nci-guide-card.variants.stories.jsx
@@ -18,6 +18,7 @@ export const SingleGuideCardWithImageAndDescriptionWithoutHeading = () => (
 		css={css}
 		html={Template.bind({})({
 			'image': img_placeholder_16x9,
+			'cardId': 'guide-card-image-and-description',
 			'altText': 'Grants and Research',
 			'modifier': 'nci-guide-card--with-image-and-description',
 			'description': 'NCI is the nation&apos;s trusted source for cancer information. We&apos;re here with information about causes and risk factors, early detection and diagnosis, and treatment options.',
@@ -53,6 +54,7 @@ export const TitleAlignedCardGroup = () => (
 				{
 					'header': 'Patients and Caregivers, with a Title Long Enough to Wrap to a Second Line',
 					'image': img_placeholder_16x9,
+					'cardId': 'guide-caregivers',
 					'altText': 'Patients and Caregivers',
 					'modifier': 'nci-guide-card--with-image-and-description',
 					'description': 'NCI is the nation&apos;s trusted source for cancer information. We&apos;re here with information about causes and risk factors, early detection and diagnosis, and treatment options.',
@@ -79,6 +81,7 @@ export const TitleAlignedCardGroup = () => (
 					'header': 'Researchers',
 					'image': img_placeholder_16x9,
 					'altText': 'Researchers',
+					'cardId': 'guide-card-researchers',
 					'modifier': 'nci-guide-card--with-image-and-description',
 					'description': 'Support for the best science underpins everything NCI does. NCI supports the best scientists and research projects through a rigorous grant application and peer review process.',
 					'buttongroup': [
diff --git a/testing/ncids-css-testing/stories/templates/cgov-home/default.stories.jsx b/testing/ncids-css-testing/stories/templates/cgov-home/default.stories.jsx
index 141f6a346..73bcdb0aa 100644
--- a/testing/ncids-css-testing/stories/templates/cgov-home/default.stories.jsx
+++ b/testing/ncids-css-testing/stories/templates/cgov-home/default.stories.jsx
@@ -154,7 +154,7 @@ const html = `
 		<section class="usa-section usa-section--light">
 			<div class="grid-container">
 				<div class="nci-title-aligned-card-group">
-					<h2 class="nci-guide-card__header">
+					<h2 class="nci-guide-card__header" id="card-caregivers">
 						Patients and Caregivers, with a Title Long Enough to Wrap to a Second
 						Line
 					</h2>
@@ -172,7 +172,7 @@ const html = `
 									here with information about causes and risk factors, early
 									detection and diagnosis, and treatment options.
 								</p>
-								<ul class="nci-card__button-group">
+								<ul class="nci-card__button-group" aria-labelledby="card-caregivers">
 									<li>
 										<a
 											href="#"
@@ -205,7 +205,7 @@ const html = `
 							</div>
 						</div>
 					</div>
-					<h2 class="nci-guide-card__header">Researchers</h2>
+					<h2 class="nci-guide-card__header" aria-labelledby="card-researchers">Researchers</h2>
 					<div class="nci-guide-card nci-guide-card--with-image-and-description">
 						<div class="nci-guide-card__wrapper">
 							<picture class="nci-guide-card__image">
@@ -217,7 +217,7 @@ const html = `
 									supports the best scientists and research projects through a
 									rigorous grant application and peer review process.
 								</p>
-								<ul class="nci-card__button-group">
+								<ul class="nci-card__button-group" aria-labelledby="card-researchers">
 									<li>
 										<a
 											href="#"