Outpatient and emergency services in rural hospitals have rarely been studied. This paper analyses routinely collected data, together with data from a survey of hospitals, to provide a picture of these services in Victorian public hospitals. The larger rural hospitals provide the bulk of rural outpatients and emergency services, particularly so for medical outpatients. Cost per service varies with the size of the hospital, possibly reflecting differences in complexity. Funding policies for rural hospital outpatient and emergency services should be sufficiently flexible to take into account the differences between rural hospitals.