African American women report less alcohol and other drug (AOD) use than Caucasian women. However, health care professionals cannot afford to dismiss AOD use as significant problems for some African-American women. Although we know much more about AOD problems in women in general, we still lack information about AOD disorders and associated factors among rural African American women. Stepwise multiple regression was used to identify the best predictors of alcohol and drug problems among 142 rural African American women who took part in a study of risk factors for AOD disorders in rural women.