Rural youth have a higher risk for lower health and developmental outcomes, often facing numerous constraints (eg, poor socioeconomic conditions, lower levels of social support, fewer recreational programs and facilities, and inadequate transportation). After-school programs have the potential to effectively deliver health-promoting activities but often face significant challenges in these areas. Ashe County is a rural community in the Appalachian region of North Carolina. Ashe County is economically depressed and its youth population has many poor health and developmental indicators. However, with more than 20 years of sustained activity, one important community resource trying to address disparities in youth health and development is the Ashe County 4-H After-School Program. To successfully overcome inherent challenges, the program has positioned itself as essential to community development, supported and retained qualified personnel, and cultivated a network of key partners to continue its efforts to provide essential youth programs for this rural community.