Alcohol use appears to be equally prevalent among rural and urban teenagers, but teenage drinking and driving may be more widespread in rural areas. An analysis of casualty collisions involving teenage drivers who had been drinking provides support for this hypothesis, revealing higher rates of such accidents in rural than in urban areas of the Canadian province of Alberta. A case study of rural teenagers in a single Alberta county replicates previous findings of more widespread drinking and driving among older youth and among males. These survey data also show that rural youth who spend more time 'driving around' with friends and those with more disposable income are more likely to drink and drive. Those with greater educational ambition and with more respect for authority figures are less likely to do so, as are those who more often attend a place of worship. An explanatory framework making reference to 'routine activities' and 'social bonds' is used to interpret these relationships, and to suggest policy implications.