The World Health Organization declared an influenza H1N1 global pandemic in June 2009, which resulted in a great deal of research. However, no studies have been published on incidence, characteristics and impact in rural emergency departments (EDs). Methods: Data were gathered from two rural EDs located in Southwestern Ontario. A retrospective chart review was performed on all visits to the hospitals' EDs with ICD-10 codes relating to influenza-like illnesses (ILI). The chart review periods were