Twenty-five percent of U.S. schoolchildren attend a rural school. Yet, rural school issues are typically subsumed by debates focused on urban problems and the misguided notion of ample resources available for their remediation. These assumptions belie the reality of the spatial mismatch that exists for rural schools, especially around mental health supports. Adverse childhood experiences and trauma disproportionately affect rural schoolchildren, putting them at greater risk of academic underachievement and other negative sequelae throughout the lifespan. Trauma-informed approaches in rural schools may mitigate the effects of childhood adversity and help close achievement gaps for rural students. Rural schools and students have needs and challenges distinct from those of urban and suburban schools, but only 2% of peer-reviewed publications address trauma-informed approaches or social-emotional learning in rural schools. More research is needed to help our 13 million rural schoolchildren develop the resilience necessary to overcome adversity and achieve healthy outcomes.