This report addresses rural/urban differences in surgical practices in commonly performed inpatient surgical procedures that are typically handled by general surgeons. National Inpatient Sample data from rural and urban hospitals in 24 states were used to examine the frequency of general surgical procedures, complications during hospitalizations and predicted resource demand. Findings indicate that rural hospitals concentrated on relatively common, low complexity procedures that can be handled by general surgeons, especially if they have received additional training in obstetrics/gynecology and orthopedics. Resource demand, length of stay, complication rates and mortality were lower for patients undergoing common procedures in rural hospitals. Rural training tracks for general surgery that provide a high case load for common general surgery, obstetrics/gynecology and orthopedics procedures may help sustain the general surgery workforce in rural areas.