Breast cancer continues to be a major health concern among Australian women. Recently, free mammography screening has been offered as a joint State and Commonwealth initiative to enable early detection. This program has particular significance in rural areas where access to health-care facilities, particularly those of a specialist nature, is limited. Attendance for screening is critical to the success of this type of program. Several lines of evidence suggest that health beliefs play a major role in compliance with recommended health behaviour. The present study investigated the role of five health beliefs: response efficacy, seriousness, concern, susceptibility and barriers to the likelihood of attending the North Coast Breast Screening Program in northern NSW. A questionnaire that measured these health beliefs was completed by 127 women who attended breast screening and 185 women who knew about the service but had not attended. Compared with those who had not undergone mammography, those presenting for screening were more health conscious, more likely to have had a mammography previously, more aware that mammography reduced the risk of developing severe breast cancer and less concerned about having a mammogram. A number of barriers to having a mammogram were also identified. The present study raises a number of concerns regarding the level of knowledge about breast self-examination and mammography as important preventive health measures among women in a rural setting.