Hospital choice for surgery affects both patient outcomes and hospital viability, a greater understanding of rural patients' surgical care-seeking behavior could enhance rural health and rural hospital financial stability. Specifically, insight on modifiable determinants of care-seeking behavior can inform policies to promote behavior that is consistent with evidence-based public health recommendations (e.g., undergoing common, low-risk surgeries at local hospitals and undergoing complex, high-risk surgeries at high-volume hospitals). Although previous research has examined rural surgical care-seeking behavior, to date, there is no published comprehensive scoping review of the literature. The purpose of this scoping review was to identify literature describing determinants of hospital choice among rural patients seeking elective surgery.