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The aim of this study was to assess rural-urban differences and temporal trends in length of inpatient stay among patients diagnosed with Alzheimer disease and related dementia (ADRD).The study sample comprised 27,313 ADRD and 27,313 matched non-ADRD inpatient discharges from Nebraska hospitals from 2005 to 2011. Descriptive statistics and multivariable regression models were used to assess rural-urban variations and temporal trends in length of stay (LOS).LOS was found to be similar for ADRD and non–ADRD-related hospitalizations. No rural-urban differences in LOS were observed for ADRD-related hospitalizations. However, there was a temporal decline in LOS for ADRD-related hospitalizations.LOS for ADRD-related hospitalizations was found to be influenced mostly by patient-level demographic and clinical factors. Hospital-level factors were not associated with LOS.