Farming and keeping livestock are the oldest professions in the world. Some of their hazards have been known from the earliest of times and farming is now the most dangerous profession in terms of mortality. Despite progress in other areas of occupational medicine, agriculture's occupational health issues have been subordinate to those of industry until only very recently. This report tells of a visit I took to a cotton farm in West Alabama as part of a Rural Medicine rotation as a third year medical student. I used the things I learned as a springboard for a focused literature review on various issues in agricultural health. Pressing health issues for farmers include toxic exposure to chemicals, trauma and injury, respiratory disease, infections, stress, and additional issues for family members. The Rural Family Physician is in a unique position to prevent morbidity and mortality by social action and early diagnosis. © 2000 by The Haworth Press, Inc. All rights reserved.