Since the mid 1990s in Australia, there has been a generally favourable policy environment with respect to rural health. However, there has been little policy attention to the systematic development of sustainable comprehensive primary health care (PHC) service models in rural and remote Australia. This study commenced with the assumption that after a productive decade of rural health activity and innovation since the first National Rural Health Strategy, the time was ripe to reflect upon what has been achieved in relation to innovative models of PHC. This review represents the first comprehensive synthesis of available knowledge relating to Australian rural and remote models of PHC. Rather than searching for more and more innovation, the need was to garner the knowledge gained over this period. Where appropriate, proven innovations and models could be identified, characterised and generalised.