Aim: To explore the impact of living with advanced chronic respiratory illness in a rural area Methods: Using an interpretive descriptive approach, semi-structured interviews were conducted with seven people living with advanced chronic respiratory illness in a rural area of Western Canada.Results: Themes that characterised the experience of living in a rural setting with a chronic obstructive respiratory illness included: a) distance as a barrier to accessing health care; b) relationships with family practice physicians; c) supportive local community; and d) lack of respiratory education and peer support.Conclusions: Whilst living with advanced respiratory illness in a rural area posed some significant challenges, experiences of "place", conceptualised as a web of relationships embedded within a local context, are an important factor in rural residents' decisions to remain in situations where distance may present significant challenges to accessing health care.