Rural-dwelling older adults are in poorer health and have less access to health care resources than urban older adults. However, little is known about specific unmet needs which exist for urban and rural populations. This study compared self-reported health status, use of services, and unmet health care needs of 106 elderly individuals residing in rural and urban settings to determine if these variables differed based on geographic location. Data were gathered on the three dependent measures using the Elderly Health Care Needs Assessment Questionnaire. Findings revealed rural older adults were not in poorer self-reported health (chi 2 = 1.85, p = .60). However, a t test showed rural subjects were significantly poorer in objective health as measured by the number of reported symptoms (t = 224, p = .02). Despite having a greater number of specific health complaints, these rural elderly individuals did not use significantly more services (t = 1.16, p = .24) or report more unmet needs (chi 2 = 3.67, p = .055), thereby reinforcing traditional views of rural older adults being in poorer health but also more self-reliant in matters related to health care. The results of this study provide information which will improve nursing practice in rural and urban settings and provide direction for further research.