The challenges associated with rural and remote health have been widely acknowledged by rural communities and the health care community for some time now. However, it is only recently that any concerted effort has begun to address these difficulties. The aim of this paper was to examine the issue of rural health and sustainability internationally with a particular emphasis on the Canadian context. This paper used a framework to: articulate the nature of rural health and sustainability; examine the historical, socio-cultural, ethical, legal, economic and political aspects of rural health and sustainability; delineate the importance and significance of rural health and sustainability to Canadian citizens, and analyze progress made in relation to rural health and sustainability. This paper concludes by cautioning that rural health and sustainability can only be enhanced by innovative strategies that employ both capacity building partnerships with rural people that are supported overall, by adequate funding allocation.