OBJECTIVE:The support and service needs of people with dementia and their carers are not always addressed in rural regions, yet family carers play an important role in supporting the person living with dementia to remain living in their own home. This study sought to identify and prioritise service and support needs of people with dementia and carers. DESIGN:A two-phase mixed methods study involving qualitative focus groups and a survey. SETTING:A rural region in Victoria, Australia. PARTICIPANTS:People living with dementia, carers and health professionals. RESULTS:Focus groups identified 12 areas of need. A follow-up survey reached consensus on the priority areas for service improvement. These included diagnosis and information access, dementia training, community understanding and carer support. CONCLUSION:Living in a rural region imposes significant challenges on people with dementia and carers. We need to find ways to address gaps in service provision for carers and people with dementia in rural settings and examine their applicability in other rural regions more broadly.