The demographic and socioeconomic impacts of the baby boomer generation turning 65 in 2011 will be magnified in rural areas where elderly are already disproportionately represented. The overall goal of a collaborative, community-based project was to improve the health literacy, health outcomes, and overall well-being of rural elderly in four small, rural communities. The methodology involved implementing four documented interventions working with Extension agents, senior center directors, librarians, and public health nurses in the communities. Extension can play a critical leadership role working with other key community stakeholders in improving health literacy, health and well-being of rural elderly.