Purpose: To synthesise the literature on informed consent in rural Australian general surgery, examining legal and professional standards, current practice, and interventions to improve patient understanding. Methodology: Scoping review of Australian and international peer-reviewed studies on risk disclosure, documentation, and consent interventions (teach-back, procedure-specific forms, digital tools, audio-visual aids) in general surgery; qualitative research on patient and clinician experiences; and RACS and ACSQHC guidance. Results: Rogers v Whitaker and current RACS/ACSQHC standards require disclosure of material risks, alternatives, and consequences tailored to individual context. However, empirical evidence reveals critical practice gaps: wide variability in risk disclosure between surgeons, frequent delegation to junior doctors without adequate training, and documentation focused on form completion rather than patient comprehension. Procedure-specific forms improve documentation accuracy but do not ensure understanding without discussion. Systematic reviews demonstrate that interactive methods, particularly teach-back and digital tools, significantly improve comprehension without increasing anxiety. Rural patients face additional barriers: lower health literacy, cultural and language gaps, time constraints, visiting surgeon models with limited continuity, and specific barriers for First Nations peoples including disregard for cultural protocols. Conclusion: Rural Australian general surgery consent remains critically under-researched despite distinctive challenges. While individual components show promise, integrated models combining procedure-specific risk frameworks, culturally safe communication, and interactive teach-back methods remain unevaluated in rural surgical settings. Critical knowledge gaps include training approaches for junior doctors and characterisation of feasible system supports within existing rural healthcare constraints.