Conscious policy and program support for the resettlement of refugees in regional and rural areas is a relatively recent trend in Australia. Resettlement is a complex process that hinges on the establishment of viable communities. This review suggests that its outcomes, especially for refugee communities, are potentially mixed. However, an appropriately resourced, well managed and well planned refugee resettlement program can potentially provide beneficial outcomes for refugees and host communities. This article draws on existing empirical data and contributions made at a VicHealth Roundtable in late 2007 to thematically explore the challenges facing rural and regional resettlement programs. Given that settlement is a dynamic process and the approaches to rural and regional settlement are evolving, this article provides 12 propositions for a more effective and integrated approach to policy and practice.