Effective K-12 leaders remain a central concern for schools and communities of all types. The purpose of this research is to examine critically the literature on issues facing leaders in rural and urban settings and present a synthesis of cross-cutting themes. The authors reviewed the theoretical and empirical literature on K-12 leadership issues in rural settings and in urban settings published between 2013-2018 in ten journals. An examination of the similarities and differences facing leaders in these settings in the United States and a discussion of the implications for leadership preparation programs is provided. Future research directions to guide the study of K-12 leadership are also discussed.