Young people in rural areas of Australia have worse health and welfare than their urban counterparts. This report provides an overview of the health and welfare issues facing young people in rural Victoria and the issues facing workers in delivering services to young people. Issues particular to regional, rural and remote youth include: rural to urban migration, health issues, drugs and alcohol, sexual health, same sex attraction, mental health, access to services, education, training and employment, youth participation, image and public space, recreation, transport, accommodation and income support. Issues for workers include: recruitment and retention, funding, health services, regional versus outlying areas, youth service models and coordination. The paper discusses diversity in youth service delivery, generalist youth workers, outreach, the role of local government, the need to build links with the local media to improve image of young people and increased local control of funding. Examples of rural youth interventions, models and programs are highlighted.