Rural areas are areas of limited resources anywhere in the world. However, rural areas in developing countries are more handicapped than their counterparts in developed countries. Nigeria is a developing country.Setting up and running a surgical service in rural areas in Nigeria has many impediments, most of which hinge around limitation of resources. Poverty and disease are prevalent in these areas, many of which are remote from cities .Roads are either in poor state of repairs or not available, access being made to such areas by footpaths or canoes. Potable water is not available in most of them.Public power supply is scarcely available and where it exists, rarely works.Conditions for modern living are absent and the inhabitants feel isolated and neglected. In spite of the many challenges, some surgeons and general duty doctors have made a success of Rural medical and surgical practice by confronting and surmounting most of the challenges.