Rationale, aims and objectives: Lack of access to surgical care is a problem that disproportionately impacts rural America. This study reports a systematic literature review analyzing the relationship between medical student exposure to rural general surgery and the production of rural general surgeons. Method: We searched MEDLINE via PubMed (1966–2020), CINAHL, and ERIC for literature describing interventions to increase interest in rural surgery during medical school. Two authors independently reviewed the articles. Results: PubMed (1966–2018), CINAHL, and ERIC searches yielded a total of 2,573 articles. After completion of PRIMSA guidelines, one study was analyzed. The study demonstrated that medical students exposed to a rural surgery rotation were more likely to choose a rural surgical practice compared to those without the exposure (48% vs 18%). Conclusion: Exposure to rural surgery in medical school may be used within medical school education to increase the number of rural general surgeons in rural America.