Data concerning rural youth drinking and driving practices were collected from 622 junior and senior high school students in northwest Ohio, utilizing an ex post facto cross-sectional survey-research design. The results suggested that 69% of the sample had used alcohol at least once. With regard to quantity of alcohol use, about 27% reported drinking four or more drinks at a sitting. Approximately 19% of the sample had driven under the influence of alcohol and 35% had ridden in a car with an intoxicated school-age driver; 35% had refused a ride from a friend who was intoxicated, while 43% had tried to stop a drunk friend from driving. No significant differences were found between males and females regarding drinking and driving but grade level was a significant moderating factor. As grade level increased, the frequency of each alcohol-related behavior increased substantially (P < 0.01). This paper presents prevalence data concerning drinking and driving among rural youth as well as recommendations for community health education program development.