The purpose of this review is to critically evaluate the available evidence from the published scientific literature on informal/family dementia care in rural and remote settings to assess the current state of knowledge, identify support implications, and make recommendations for future research. A systemic review of the literature indexed in ISI Web of Knowledge, PsychInfo, Medline, Healthstar, CINAHL, EMBASE, and Sociological Abstracts was conducted. Data were extracted from papers meeting inclusion criteria: peer-reviewed papers that focused on dementia or Alzheimer's Disease (AD), and examined informal or family caregiving in relation to persons with AD or dementia in remote or rural locations. The search identified 872 articles for review, reduced to 72 after removing duplicates and articles not meeting inclusion criteria. Of the 72 remaining, 26 are included in this review focusing on informal/family caregiving. A previous review focused on the 46 studies on formal/paid care. Four themes that correspond to the current state of knowledge about rural informal/family dementia caregiving in the 26 included studies were: service use, carer experience, support and education, and rural perceptions of dementia. Despite the growing body of evidence over the 20 years of this review, and the widespread interest in family dementia caregiving generally, much of the research exploring family caregiving in rural areas focuses on the experience, use and barriers to formal service provision. There is limited work examining the experiences of rural caregivers and their education and support needs. More research is needed about the impact of rurality on caregiving and the education and support needs of rural informal family caregivers. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.