Approximately 36% of the rural Australian population is 65 years and older. In fact, many rural and remote communities have higher proportions of older people than metropolitan centres. The rate of growth, patterns of migration, higher levels of health risk factors and of social and economic disadvantage all impact on rural healthy ageing. Older people in rural communities have become marginalized by longstanding misconceptions about rural life and urban-centric policies, much of which goes unchallenged because of a paucity of research in key areas and a lack of intrarural research. Understanding the complexities of rural healthy ageing is challenging, and more research is required to develop a stronger empirical base. The aim of this review is to critique the literature related to rural ageing in Australia to identify the issues and challenges for rural healthy ageing and implications for policy and practice.