Spirituality plays a vital role in adjusting to chronic illness and rehabilitation nurses strive to gain understanding of their patients' spirituality in order to improve patient care and outcomes. The purpose of this qualitative study was to explore the nature of spirituality in chronically ill rural dwellers and how it relates to their illness. As a part of this pilot project, 10 women with chronic illness volunteered to participate in a phone interview to discuss their spirituality. Content analysis was used to analyze the data. The theme Means the World to Me described what spirituality meant to participants. The following themes described how spirituality related to chronic illness: I Am Not Alone, Putting on a Happy Face, Others Are Worse Off, Transcending Despair and Letting Go. Participants were able to use spiritual coping measures to transcend despair. Results from this study provide rehabilitation nurses with insight into the spirituality needs of chronically ill rural-dwelling women.