Book excerpt: In this issue of Pediatric Clinics of North America, guest editor Dr. Mary C. Ottolini brings her considerable expertise to the topic of Challenges of Pediatric Practice in Rural America. Nearly one in five children live in rural America, and children and adolescents living in rural communities experience significant health disparities compared to those in urban areas. This issue explores current, relevant topics related to the challenges of providing care to children and adolescents in rural locations. Contains 13 relevant, practice-oriented topics including rural community approaches to address childhood obesity; mental health challenges in rural environments; substance abuse and neonatal opiate withdrawal syndrome in rural environments; transport challenges; telemedicine; pediatric injuries; and more. Provides in-depth clinical reviews on the challenges of pediatric practice in rural America, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.