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Scholars have noted the importance of the leadership context - yet there is a dearth of scholarship on rural school leadership. Further, the increasing number of life-threatening crises influencing schools suggests more needs to be done to prepare school leaders for these events. This paper provides insights into preparing rural school leaders by highlighting how the framework of in extremis leadership (Kolditz, 2010) may be relevant. We draw on qualitative interview data from superintendents of rural school districts in the U.S. state of North Carolina to highlight the life-threatening decisions they had to make during COVID-19. Findings suggest in extremis leadership aligns well with rural values, such as egalitarianism and a learning orientation.