Rural populations of the United Kingdom and Scandinavia have lower hospital discharge and incidence rates for hip fractures than urban ones. We compared hospital separations from fractures in rural health regions of Victoria, Australia, with those in metropolitan regions. Fractures were grouped into those commonly (1A), often (1B) or not often (2) associated with osteoporosis. For group 1A fractures, we found rural separation rates were significantly higher among both men and women who were aged either 20-24 or 45-64. The rural separation rates for group 1B fractures were also significantly higher in these age groups but only among men. For group 2 fractures, rural separation rates were significantly higher among young adults. Fractures of the neck, trunk, radius and ulna, but not neck of the femur, contributed to the rural excess of group 1A fractures. If rural adults are not hospitalised more often, risk factors for group 1 and group 2 fractures, which in the middle aged includes osteoporosis, may be more prevalent in rural Victoria. Our findings suggest that international studies of rural-urban differences in fracture rates are needed which include a range of anatomical sites.