This study examines the moderating influence of rural residence on the associations between health locus of control (HLC) beliefs and psychological well-being. Two hundred and twenty-four breast cancer patients were surveyed. The results revealed that rurality interacted with HLC beliefs in predicting psychological adjustment. The pattern indicated that, whereas endorsing external forms of locus of control can be detrimental to the psychological well-being of urban breast cancer patients, the same is not true for rural breast cancer patients. For rural breast cancer patients, powerful others locus of control was beneficial for and chance locus of control was unrelated to well-being. Implications for future research and medical care are discussed.