In the United Kingdom (UK) there is currently an upsurge of interest in rural affairs. This brings the potential to address some of the gaps in rural health care research. The appropriate description and measurement of rural deprivation is one area consistently identified by UK rural practitioners and policymakers as urgently requiring evidence. Appropriate identification and measurement of deprivation within a rural context is important so that primary care resources can be targeted at those with greatest need. It is believed that current measures of deprivation are inappropriate for rural settings, but relationships between life circumstances and health are only beginning to be addressed by empirical research. In this paper we propose an approach to researching rural deprivation. It is important to be clear about definitions of rurality and deprivation and about the purpose of measurement. The requirement to test a range of indicators for their association with health status and health care need in rural areas and to gather more locally relevant data within primary care settings is highlighted. The relevance, for primary care, of exploring rural deprivation is suggested, along with ideas about a way forward in generating knowledge that can help to characterise and measure rural deprivation in a more sensitive manner.