Are the medical problems of the ambulatory elderly in a nonmetropolitan area different from the problems of the metropolitan elderly? What relation does the availability of physician resources in a nonmetropolitan area have to the care delivered to the elderly? The study involved an analysis of 965 patient records sampled from the office practices of 16 family practitioners and 12 general surgeons. Data were extracted using the survey instrument developed for the national ambulatory medical care survey (DHEW, 1974). Results were obtained describing patient status, presenting problems, principal diagnoses, reasons for visit, and disposition. Comparisons of the medical problems managed by the family practitioners were made with those managed by the general surgeons. Problems managed by the nonmetropolitan physicians were compared with the data on the elderly obtained from the National Ambulatory Medical Care Survey. The data suggest that nonmetropolitan physicians, regardless of specialty, manage a broad range of chronic and acute problems. The survey of office records, however, does not provide information about how the elderly obtain access to other services essential to a coordinated, comprehensive system of health care.