Abstract: Although most people gamble safely, national prevalence rates indicate that approximately 0.2 to 1% of the Australian population experience problems with gambling. An issue that has not been extensively researched in Australia is whether the nature of gambling, and the associated harms is consistently observed across the nation. In particular, are there are differences between metropolitan and rural areas in people’s experiences with gambling and the associated impacts? A qualitative study involving interviews with 10 help-seekers affected by problem gambling examined the nature of gambling in rural and remote areas and the potential barriers and challenges associated with help-seeking. Particular issues relevant to rural gamblers that set them apart from metropolitan gamblers were: limitations in leisure choices in rural areas; the problem of social familiarity in relation to anonymous help-seeking; and the dearth of specialized services. This study highlights the need to consider the role of rural-specific barriers, motivating and protective factors in developing service delivery models and specialized interventions for problem gambling in rural and remote communities.