This study uses a national web-based survey and case study investigation to better understand the types of public transportation services that exist in rural and small communities, how these services are organized, financed, and delivered, and how they are used by older adults (typically age 65 and over). The results indicate that providers offer a diverse array of transportation options for older adults, and frequently partner with social services, government, and other entities to finance, operate, and/or market their services. Providers frequently use partnerships to assist with marketing and outreach, as well as to leverage fiscal resources and professional expertise. These partnerships are frequently the source of ideas to improve service provision. Providers face significant financial challenges that frequently obstruct their ability to provide the types and amounts of services they would prefer to offer. They are required to be adaptive, leverage unique funding sources, and to reduce costs as much as possible, including occasionally through the use of volunteers to provide some services. Providers regard direct outreach, word-of-mouth marketing, and personal contact as critical to gaining trust with older adults and encouraging their use of transportation services. The study results also highlight a lack of knowledge as to the extent of older adult use of most transportation services in rural and small communities, as few service providers devote resources to tracking older adult use of their service. This limits our ability to determine whether older adult transportation needs in these communities are being effectively and adequately met.