Referendum Question 4|
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| Choice | Votes | % |  
| Yes | 1,302,180 | 67.20% |  
| No | 635,580 | 32.80% |  
| Valid votes | 1,937,760 | 100.00% |  
| Invalid or blank votes | 0 | 0.00% |  
| Total votes | 1,937,760 | 100.00% |  |
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|  Congressional district results
 
| Yes   90–100%    80–90%    70–80%    60–70%    50–60%  | No   90–100%    80–90%    70–80%    60–70%    50–60%  | Other   Tie    No votes    |  | 
| Source: Maryland State Board of Elections | 
Question 4 was a voter referendum to amend the Constitution of Maryland in order to legalize cannabis for adult use in Maryland. The referendum was approved overwhelmingly, with more than twice as many voters voting in favor of it than against it and winning in all but one county, on November 8, 2022. It went into effect on July 1, 2023.