School psychologists serve the learning needs of students through assessment, intervention, and consultation. The school psychologist can often be the only mental health professional who travels into rural communities. In an effort to adapt to this context of clinical isolation, rural school psychologists develop specialty competencies to serve their clients. This study explores the competencies required among school psychologists practicing in rural regions of Saskatchewan. Eight rural school psychologists participated in a "thematic Delphi" process to describe the competencies needed in rural school psychology. The participants engaged in three rounds of data collection and collective data analysis and arrived at a strong level of agreement on the final outcomes. The findings describe rural school psychology knowledge (i.e., community knowledge, generalist knowledge, and system knowledge), skills (i.e., relationship skills, core psychologist skills, efficiency skills, and communication skills), attitudes (i.e., flexibility, openness, and compassion), and behaviors (i.e., being responsive, being empowering, being available, and being procedural). The present study results contribute to better defining and understanding the multiple roles and practices of rural school psychologists. Recommendations of the study invite psychologists, clinical supervisors, and psychology training programs to incorporate an emphasis on interpersonal relationships, a generalist approach to psychological services, and consider creative practices of rural practitioners to the initial training and ongoing professional development of school psychologists.