Since the early 1980s, there have been a number of attempts to use rural service centres as a policy instrument for regional development in South Africa. This paper traces the evolution and reformulation of the strategy and concept through an examination of six case studies. These demonstrate how rural service centres were incorporated in regional development strategies and how the conceptual model was modified, not only in response to local conditions, but also to the prevailing policy environment. While the early case studies tended to place more emphasis on spatial location, physical form and the range of functions at rural service centres, there has recently been a shift in emphasis to the management of service delivery systems through well-located centres in rural areas. Implementation problems in the earlier period were largely due to the absence of a supportive institutional environment, while in the post-1994 period the evolving local government transformation process cut across successive pilot initiatives. In the KwaZulu-Natal province, a favourable policy environment has been established for the inclusion of rural service centres as part of the spatial development frameworks and service delivery systems for local municipalities. There are, however, severe capacity constraints and a tendency for the marketing and production facet of rural service centres to be lost in the drive to co-ordinate service delivery. The paper concludes with an identification of some preconditions for the successful establishment of rural service centres in developing countries.