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As anti-LGBTQ+, specifically anti-trans, legislative efforts escalate in statehouses across the U.S., schools and educators must make important policy, curricular, and instructional decisions surrounding LGBTQ+ students under immense public scrutiny. While scholars find inclusive and protective policies and practices improve LGBTQ+ students’ experiences in schools, access to these supports varies by school and community factors. This review considers the factors of rural schools and communities and their influence on LGBTQ+ students’ risk and resilience. Findings from the literature suggest rural LGBTQ+ students experience adverse environments, fewer affirming resources, greater internalized homophobia, and poorer academic and health outcomes than their urban and suburban peers.