Background: Rural general surgeons are essential for equitable surgical care in Australia. Despite recent RACS rural training initiatives, evidence guiding effective rural surgical education remains limited and fragmented. This review synthesised current knowledge on rural general surgical education in Australia, to identify gaps for developing sustainable training models aligned with RACS competencies. Methodology: Structured narrative review of MEDLINE and grey literature (2000-2025) from surgical colleges and rural health agencies. Eligible publications described rural/regional Australian general surgery education, teaching models, supervision, simulation-based training, operative exposure and non-technical skills. Studies were synthesised thematically and mapped to RACS General Surgery SET competencies. Results: A limited body of peer-reviewed studies and key policy documents were identified. Emerging themes included traditional apprenticeship-style supervision models, variable access to operative exposure in smaller centres, and recent initiatives using simulation or mobile skills training to compensate for limited case-mix. Evidence was particularly limited for structured rural teaching frameworks and systematic non-technical skills development specific to rural general surgery contexts. This gap persists despite RACS incorporation of NOTSS into Surgical Education and Training programs. Priority gaps included structured simulation access, formalised perioperative teaching frameworks, and systematic mentoring in situation awareness, decision-making, communication and teamwork. Conclusions: Current literature provides limited guidance for structured rural general surgical education in Australia, with training programs remaining metropolitan-centric. Defining context-appropriate models for regional centres could strengthen rural pathways and support RACS workforce sustainability goals by addressing non-technical skills and competency-based assessment.