Background: Although rural adolescents use of alcohol is at some of the highest rates nationally, rural adolescent alcohol use has not been studied extensively. This study examines how community attitudes and behaviors are related to adolescent drinking in rural environments. Methods: Data were gathered in 22 rural communities in the Upper Midwest (North Dakota, South Dakota, Wisconsin, and Wyoming). Surveys were collected from 1424 rural sixth- to eighth-grade adolescents and 790 adults, including parents, teachers, and community leaders. Census data were also collected. Results: Drinkers differed from nondrinkers by the following factors: higher perceptions of peer, parental, and overall community drinking, as well as lower levels of parental closeness and religiosity. Factors distinguishing binge and nonbinge drinkers were increased drinking to reduce stress, drinking to fit in, perceptions of peer drinking, and perceived lack of alternatives to drinking. Parents were significantly less likely to perceive adolescent alcohol use as a problem than other community adults; school officials were most likely to perceive it as a problem. Parental perceptions were also the least correlated to actual adolescent use, while adolescent perceptions were the most highly correlated. Conclusions: Community factors such as overall prevalence of drinking, community support, and controls against drinking are important predictors of reported use in early adolescence. School officials were more likely to view adolescent alcohol use as a problem than were parents. School officials' perceptions of adolescent use were also more related to actual adolescent use than were parental perceptions of adolescent use. (Contains 3 tables and 2 figures.)