Because increasing numbers of physicians are being trained in specialized medicine, health professional shortage areas remain common in the United States, and the role of physician assistants (PAs) in health services provision is becoming increasingly important, especially in rural and underserved areas. By most accounts, there is a shortage of PAs in the United States, particularly in rural areas. A nationwide survey was conducted in 1994 to determine what attracted PAs to rural settings and what they found satisfying about their work and community. This study involved a random sample of 1,263 PAs who practiced in rural (nonmetropolitan) areas of the United States. A 15-item scale was developed to measure job satisfaction. A statistical model was tested for its ability to predict levels of job satisfaction using multiple regression analysis. Independent variables included demographics, practice, and community factors. Findings indicated that rural PAs were generally satisfied with their work. The most significant predictors of satisfaction included practice factors (e.g., importance of autonomy and a good relationship with the supervising physician), extent of practice responsibilities (e.g., regular and on-call hours and the percentage of PAs' patient load that was not discussed with the supervising physician), and community factors (e.g., community satisfaction).