High rates of alcohol consumption are common in rural and remote areas of Australia, and there is a lack of support services to reduce alcohol-related harm in these areas. This paper describes some of the issues facing rural and remote communities in Victoria in relation to alcohol-related harms, and explores the range of practical prevention and early intervention strategies available to them to prevent and reduce such harms. Issues discussed include the rates of alcohol consumption in rural Victoria and factors that influence resultant harm, the challenges associated with reducing harm from alcohol consumption, and strategies for prevention and early intervention. The paper provides a number of case studies.