Regional public universities play a critical role in providing postsecondary education access in rural communities. This chapter explores that role by considering the distribution of these institutions across geographic areas and how that shapes the postsecondary options available to rural students. Federal data are used to demonstrate disparities in revenue sources between rural institutions and those in cities and suburbs, and a recent survey of individuals leading state higher education agencies and systems highlights the most pressing issues rural-serving institutions face today. Policy recommendations in this chapter include the expansion of rural broadband access and increased expenditures on instructional activities. The chapter concludes with a call for additional research on rural students' retention and completion outcomes, in-college experiences of rural students, and the specific financial challenges facing rural-serving institutions.