In this issue of the “Reviews and Reports,” Drs. Waldman and Perlman heighten our awareness of the unique challenges presented to individuals living in rural environments and also having a developmental disability. The old expression “out of sight, out of mind” certainly comes into play here. But there is hope; while limited, there are examples of attempts to remedy this situation (see ruralinstitute.umt.edu/). As the authors reveal, a significant disparity exists between numbers requiring care and numbers of trained caregivers available. From these authors comes a “Call to Action."