This paper provides a consolidated summary of legislative provisions contained in the Patient Protection and Affordability Act of 2010 (PPACA) that have particular meaning to rural residents and to the delivery of services in rural areas. Changes from the Health Care and Education Reconciliation Act of 2010 are incorporated. This paper serves as a rural roadmap of the PPACA for use by advocates, analysts, practitioners, and policy makers focused on rural health as they continue the important task of improving the system as it affects rural interests. Included in the paper are rural-relevant highlights of the legislation and detailed tables for each section.