This study aimed to describe policies and practices of online grocery retailers that may affect healthy food access, including retailers participating in the U.S. Department of Agriculture’s Supplemental Nutrition Assistance Program Online Purchasing Pilot. This was a cross-sectional, quantitative content analysis of 21 online grocery retail websites from November 2019 to January 2020. Most retailers (95%) added fees to online orders. Among pilot retailers, 38% added ≥ 3 fees, and 50% required a minimum order > $15. Few retailers (29%) displayed Nutrition Facts Labels on all products, including 50% of pilot retailers. All retailers collected personal information from shoppers and automatically shared data with affiliated companies. High fees, limited access to nutrition information on retailer sites, and lack of data privacy are prevalent in online grocery retail settings, including among Online Purchasing Pilot retailers. Online retail practices may perpetuate disparities in healthy food access by discouraging use through fees and making nutritious food choices difficult.