A qualitative research study was conducted to explore leadership competencies of presidents of public universities with enrollments of less than 7,000, located in small rural communities and distant locations in the Upper Midwest. The context of higher education is constantly evolving. Internal pressures from faculty and students, as well as external factors such as finances, new technologies, and stakeholder demands play a role in determining the future of academic institutions and the success of their leadership. Much literature has been written regarding higher education leadership, best practices for success, and future changes that should be made to maintain sustainable institutions, especially in rural settings. However, little research has been conducted focusing on higher education institutions set in rural locations that serve primarily rural stakeholders. This study added to the knowledge on rural educational institutions by: (a) using in-depth interviews to explore the context of leadership at rural higher education institutions, (b) analyzing skill sets identified by the presidents interviewed, and (c) attempting to identify suggested competencies that may help future leaders, or those selecting future leaders, to better prepare for conditions that lie ahead. During the course of this research, it became apparent that effective leadership depends upon a process, and that process was used to develop a grounded theory model described in detail within this dissertation. The resulting model highlights the complexity and breadth of consideration participating presidents have taken in the process of leading their institutions. This process depicts how presidents must develop strategic foresight that includes a consideration of the culture and context of their institutions as well as the needs of a vast array of stakeholders in order to advance their institutions and create sustainability in their institutions for the future. After developing foresight, leaders assess strengths and weaknesses of each opportunity that presents itself. Then leaders work on empowering faculty and staff at their institutions to move forward. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]