Background: Chronic Obstructive Pulmonary Disease (COPD) is more prevalent in rural areas than in non-rural areas due to factors such as limited access to healthcare; however, no known studies have systematically reviewed evidence related to the impact of self-management interventions on rural adults with COPD. Purpose: Systematically review telehealth and non-telehealth self-management interventions delivered to adults with COPD in rural areas. Methods: Six electronic databases were searched to identify eleven eligible articles. Results: Six studies delivered telehealth interventions, while five delivered non-telehealth interventions. Six interventions (54.5%) reported the use of a behavioral theory, and four (36.4%) employed a randomized control trial (RCT) design. Three studies (n = 2 telehealth; n = 1 non-telehealth) reported significant improvements in self-management efficacy, five (n = 3 telehealth; n = 2 non-telehealth) reported improvements in quality of life, four (n = 1 telehealth; n = 3 non-telehealth) demonstrated improved exercise capacity, and four (n = 2 telehealth; n = 2 non-telehealth) reported improved COPD knowledge. Discussion: There is promising evidence that telehealth interventions could be as beneficial as non-telehealth interventions for improving COPD self-management in rural areas. Translation to Health Education Practice: Community-based needs assessments in rural areas may help determine the optimal method of delivery (i.e., telehealth and/or non-telehealth strategies) for local COPD self-management interventions.