Rural men form a group particularly vulnerable to health problems such as suicide and psychological distress and rarely use health services. Like any social health inequality, this situation is a challenge regarding many values of social work. Despite the worrying portrait, rural men’s psychological health remains largely neglected in Québec, like in most of the industrialized countries, which contributes to its invisibility. This paper aims to a better understanding of the objective and subjective realities that influence their psychological health. It presents the main paradigms used to understand rural masculinities and suggests future directions for research.