Rural Surgery (RS) has been practiced and defined in developed countries (i.e.,USA, Canada, and Australia) comprised largely of a huge land mass as general surgery practice done outside of their urban communities. It is characterized as a surgical practice that is rewarding as the surgeon is placed in professional isolation cloasely-knit personally in the community as he/she is expected to deliver even in the absence of more sophisticated health technologies snd surgical techniques. The authors subscribed to these decriptions but would like to advance a more progressive and bottom-up approach of defining RS especially in an archipelagic developing country like the Philippines with 7107 islands. RS practice is generally defined as general surgery with heightened inclination on incorporating the social determinants of health on the Rural Surgeon’s management algorithms and surgical Methods. While he/she performs the common appendectomies, cholecystectomies, inguinal hernia repair and wound debridement, half of his/her management plan is formulated before and after the patient’s admission. A keen inclination on how the health systems work and referral system is a large component of the plan. Rural Filipino patients are unique in the sense that mostly sought consult after initial presentation or complications of their disease because of compounding social factors like limitation in geographical access, financial capability, health-seeking behavior, and education as compared to their urban counterparts. The authors would suggest that defining RS in developing country as the practice of general surgery performed in disadvantaged areas with surgical management concocted with heightened considerations in the social determinants of health and the surgical health system of the area. Thereby, the authors also advocate that RS in the Philippines be more inclusive and should be aligned in the ongoing implementation of the Universal Health Care Act while it embraces the inevitable facets of challenging social determinants of health.