In general, older women who live in rural settings have less access to adequate health care and other services, and may be particularly vulnerable to domestic violence as a result of geographic and social isolation. As such, when older rural women are abused, they are often unable to gain access to preventative services due to their isolation. The current study compared the abuse histories of 7,178 rural and 7,614 urban older female victims of abuse, neglect, or exploitation. Data were gathered from the Illinois Elder Abuse and Neglect Program, which collects information on elder abuse among those aged 60 or over in 74 rural and 13 urban counties in Illinois; data for this study included reports of substantiated abuse received during the years 1989 through 2001. Results of chi-square statistical analyses comparing the two groups indicated that rural women suffered more physical abuse, emotional abuse, and deprivation than their urban counterparts. Urban women, on the other hand, suffered more passive neglect than rural women. In 88 percent of the rural cases, and in 86 percent of the urban cases, victims were willing to accept intervention services following abuse substantiation. Abuser characteristics were also examined; most perpetrators of abuse and neglect were non-caregivers and offspring who had no legal responsibility to the victims. The nature of the data does not allow for an explanation of why rural women suffer more from certain types of abuse than others. Policy implications arising from the current findings indicate that elder abuse permeates all segments of society, including those in rural settings, and as such, prevention and intervention services should be distributed equitably throughout the population. Figures, tables, references