It is important for therapists to be knowledgeable about the impact of the environment on children's participation patterns and activity preferences. This study investigated the activity preference and participation among school-age children living in urban and rural locations. The participation patterns and preferences for activities of 58 typically developing children (32 males and 26 females; response rate of 38.7%) aged 8-12 years were assessed across both urban (n = 24) and rural (n = 34) regions of southwest Victoria, Australia. The participation patterns and preferences for activities were assessed using the Children's Assessment of Participation and Enjoyment and Preferences for Activities of Children (CAPE/PAC). An independent samples t-test was used to determine whether significant differences existed for the CAPE/PAC scores for urban and rurally based children as well as boys and girls. Significant differences were found between the scores of children living in urban and rural areas on the following subscales: CAPE Diversity, CAPE Intensity, CAPE Whom, CAPE Where, PAC Physical Preference, and PAC Social Preference. A significant difference for rural and urban groups was found on the following CAPE activity types: Recreation Diversity, Recreation Intensity, Social Diversity, Social Intensity, Self-Improvement Diversity, and Self-Improvement Intensity. Rurally based children were engaged in a broader range of activities and did so more frequently than urban children. Differences in gender were identified with girls preferring to participate in social and skill-based activities and being more likely to participate with friends or people outside their home. However, there were no significant differences in the participation patterns of boys and girls. Physical, social, and structural aspects of the location where a child lives impact the frequency, type of activities, and whom a child participates with most frequently in out-of-school activities. The activity participation of boys and girls in Australia has become quite similar.