Over 14,000 women aged 45-50 are participating in the Australian Longitudinal Study on Women's Health, which is designed to track the health of Australian women for 20 years, and to understand lifestyle and healthcare factors that influence women's health. The study deliberately overrepresents women from rural and remote areas. This analysis of baseline data from the study compares the responses of women living in urban areas (capital city, other metropolitan), large rural centres, small rural centres, other rural areas and remote areas (remote centres, other remote areas) of Australia. The data show that while women in this age group who live in rural and remote areas have similar levels of self-rated health, they have significantly fewer visits to general practitioners and specialists (P < 0.001) and more visits to alternative healthcare providers than women living in urban areas. Rural and remote area women were also more likely to undergo gynaecological surgery than women living in urban areas (P < 0.001). Other results suggest that being overweight is more common among women from rural and remote areas, and that these women also report lower levels of stress than women from urban areas (P < 0.001). Further follow up will allow any divergence in health and healthcare equity to be explored as these women get older.