BACKGROUND There is a serious shortage of health professionals in rural and remote areas in Australia and world wide. The purpose of this article was to add to existing information about allied health students, particularly occupational therapy students, and rural and remote practice by reviewing the literature on occupational therapy students' perceptions of rural and remote practice. A variety of influencing factors were identified, as were the main characteristics of rural practice in relation to the future employment of students. The effect of undergraduate rural training programs on students' perceptions was identified. METHODS The shortage of rural and remote health practitioners is well documented. Because rural and remote practice is characterised by a diversity of healthcare needs, rural health professionals need a variety of knowledge and skills. This diversity may attract rural health professionals and encourages undergraduate students to consider rural and remote practice. A student's rural background was reported to be one of the strongest factors in their decision to work rurally, and an undergraduate rural program is one useful strategy to overcome the rural health professional shortage. Undergraduate rural programs promote students' positive perceptions of rural and remote practice by exposure to a rural location, and factors such as rural fieldwork experience and fieldwork supervisors are likely to be influential. Negative influential factors include a student's desire to work as a 'specialist', and personal, social and professional factors, such as a lack of professional development opportunities in a rural setting. CONCLUSIONS The relationship between a student's rural background and the likelihood of working in a rural area is evident. However, few studies have examined the influence of the undergraduate program's subjects. Further studies should explore the influence of a student's perceptions of the undergraduate rural program on their decision to work in a rural setting.