A debate continues between two camps: those who see “ethics as ethics” regardless of place and others who believe that ethical challenges are somehow different for rural physicians than for their more urban counterparts. This research examines the ethical perspectives of urban, suburban, and rural physicians to identify differences based on practice location. Over 3000 Georgia physicians responded to questions concerning their experiences with ethical dilemmas in eight domains: payment /conflict of interest; patient access; truth telling/professional conduct; boundary/dual role issues; patient autonomy; sociological/cultural issues; stress/burnout; and ethics training/leadership. Descriptive statistics and contingency tables were used for statistical analysis. Higher proportions of physicians in rural practice reported experiencing ethical issues related to patient access to acute and specialty care and quality care, stress and burnout, and lack of anonymity, the same group with the least access to resources for ethical decision-making.