Objectives: The objectives of this research were to investigate the equity of brain injury rehabilitation services to rural and remote areas of the state of New South Wales (NSW), Australia, and to describe the experience of people who access and who deliver these services. Methods: Semi-structured interviews were used to gather information from people with acquired brain injury (ABI), their families and rural and remote NSW health, rehabilitation and support services staff who worked with people with a brain injury. Data analysis was guided by an interpretative phenomenological analysis approach. Findings: Fifty-nine service providers representing 35 organizations, six people with ABI and seven family members participated in the research. Three key issues emerged from the data: (1) Limited access to appropriate brain injury rehabilitation; (2) Difficulties funding, recruiting and retaining appropriately skilled health, rehabilitation and support staff; and (3) Inadequate current services resulting in a number of unmet needs. Conclusion: Current models of practice for ABI rehabilitation are not appropriate to address the significant inequalities and gaps in available services for people with brain injury in rural and remote NSW. Alternative innovative models are needed to reduce the disparity of access and outcomes for these people.