This session explored the extent to which active living theory, methods and interventions need to be modified for use in rural communities. The workshop began with a brief presentation exploring how rural residents are a high risk, high priority population, and reviewing geographic, cultural and political factors that necessitate different approaches to active living initiatives in such communities. Investigators reported on three recently completed rural active living research projects, with an emphasis on how the study communities differ from urban and suburban communities, and how active living methodologies were modified to accommodate these differences.