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Rural women Veterans represent a vulnerable, underserved population who encounter significant obstacles when seeking quality mental health services. However, there is a paucity of research devoted specifically to this population. To address this gap, we examined the mental health status of a group of rural women Veterans, including psychological distress, posttraumatic stress disorder (PTSD) symptoms, insomnia, suicide risk, the incidence of military sexual trauma (MST), and the perceived stigma and barriers to seeking care. One hundred and one rural Veterans interested in a women’s wellness retreat program completed written inventories. Overall, they demonstrated significant levels of psychological distress, with averages ranging between the 82nd and 88th percentiles for depression, anxiety, and somatization symptoms. In addition, 35% scored above the clinical screening level for general distress, 40% reported symptoms above the cutoff level for probable PTSD, and 70% demonstrated clinical levels of insomnia. Notably, 36% of the total sample evidenced a risk for suicide, and 68% reported MST. MST was significantly associated with increased levels of psychological distress, PTSD symptoms, and suicidality. Sixty-nine percent of participants reported at least one barrier to seeking mental health services, with scheduling difficulties, distance from facilities, and internalized stigma endorsed the most frequently. The mental health status of rural women Veterans, coupled with perceived barriers and internalized stigma, underscore the urgency of developing innovative strategies to increase the accessibility and utilization of effective services for this at-risk population.