Recent headlines have brought attention to the effects that unfavorable demographic and fiscal conditions are having on postsecondary education institutions. Among those most acutely feeling the pressures are likely to be institutions located in rural communities that are seeing more rapid population declines and lagging median income. This article provides data showing how conditions at these institutions have changed in recent years. It focuses on public institutions even though conditions may be similar at rural private institutions, because the responses at public institutions to the challenges will likely differ dramatically due to their status as state- and locally owned and controlled institutions. In addition to the direct job opportunities colleges provide there are the spillover effects on the local economy from the related businesses they support and from the presence of students and their purchases from local merchants. With so much of a community's prosperity depending on the health of these institutions, it is inevitable that their fate will become an issue for state higher education leaders and policy makers. And while these patterns are also found with private institutions, lawmakers have considerably more authority to determine what happens to struggling state-owned institutions. Policy makers and higher education leaders at the state level, and institutional presidents and governing boards at the local level, need to determine how these institutions can continue to serve their important roles as key points of access to postsecondary education, as institutions of cultural importance, and as a critical driver of local economies.