This chapter provides an overview of considerations for psychiatry residency training in rural environments. Rural communities are commonly underserved in medical care, especially in subspecialties such as psychiatry, with a lack of practitioners being a major issue. Rural-based psychiatric training offers an opportunity to improve the mental health of these populations by providing a mechanism to recruit and retain psychiatrists in communities that desperately need them. Rural programs and tracks also have the prospect of providing psychiatric training with specific qualities that certain residents value. There are many components to building and running successful psychiatry training programs and activities in rural environments. Having a vision for the type of psychiatrist desired in the community, how to integrate the psychiatrist into the community, how this practitioner will improve the community, how to provide quality educational experiences, and crucial characteristics of residents and faculty are essential for guiding the design and implementation of educational programming that is meaningful and integral.