The challenges of practicing child and adolescent psychiatry in rural areas include not just the limited access to medical resources but also the geography; the population density; the ethnic, racial, and cultural diversity; and the ethical dilemmas encountered in rural practice. This CCB provides a forum where rural child and adolescent psychiatrists can discuss these and other issues they face in their own practices, and child and adolescent psychiatrists moving to rural areas can learn how to make the transition to rural practice successful. Areas discussed include the multiplicity of needs and available work for child and adolescent psychiatrists in rural areas, the realities of rural practice, and strategies for adjusting one’s practice to make it viable over the long term. Personal and professional challenges such as building in time for family, keeping up with continuing medical education, and finding collegial contact and support are addressed. This breakfast also highlights financial realities of rural practice, dealing with limited resources, contract and negotiation issues, the use of physician extenders and professional collaboration, and strategies to help upgrade the quality of care in your area.