Objective To describe the effect of rural placements and rural background on pharmacy students’ intention to practice rurally. Methods This cross-sectional study invited 250 pharmacy students to participate in the mixed-methods survey. Pharmacy students were invited to participate at the National Australian Pharmacy Student Association (NAPSA) annual congress held in Bendigo, Victoria in January 2014. This study aimed to investigate the pharmacy students’ intention to pursue a rural career. Results A total of 156 participants responded to the survey. Participants were mostly female (68%), and were aged under 30 years with the majority aged 20–24 years (116, 74%). A third of the respondents were (32%) identified with having a rural background, and about half of all the participants (53%) had undertaken a clinical placement. Students who came from a rural background were more likely to work in rural areas than urban after graduation (p < 0.001). However, when both rural and urban background students undertook a rural placement there was no difference in their rural career intentions. Additionally, the majority of students (93%) considered rural placements as beneficial to their training. Standards of health care and social isolation features are major barriers to rural practice and facilitators included increased patient interaction and community engagement. Conclusion This study shows that rural exposure (rural background or rural placement) can positively affect students’ intentions to participate in the rural workforce regardless of their background. Students have a desire to understand rural health and are likely to consider a rural career.