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We performed a scoping review describing available literature on barriers and facilitators impacting participation in pediatric clinical trials in rural and community\u2010based (nonclinical) settings. Articles identified via PubMed, CINAHL, Embase, and Web of Science were independently double\u2010screened at title\/abstract and full\u2010text levels to identify articles meeting eligibility criteria. Included articles reported on recruitment or retention activities for US\u2010based pediatric clinical studies conducted in rural or community\u2010based settings and were published in English through January 2021. Twenty\u2010seven articles describing 31 studies met inclusion criteria. Most articles reported on at least one study conducted in an urban or suburban or unspecified community setting (<jats:italic>n\u00a0<\/jats:italic>=\u00a023 articles; 85%); fewer (<jats:italic>n\u00a0<\/jats:italic>=\u00a010; 37%) reported on studies that spanned urban and rural settings or were set in rural areas. More studies discussed recruitment facilitators (<jats:italic>n\u00a0<\/jats:italic>=\u00a025 studies; 81%) and barriers (<jats:italic>n\u00a0<\/jats:italic>=\u00a019; 61%) versus retention facilitators (<jats:italic>n\u00a0<\/jats:italic>=\u00a015; 48%) and barriers (<jats:italic>n\u00a0<\/jats:italic>=\u00a08; 26%). Descriptions of recruitment and retention barriers and facilitators were primarily experiential or subjective. Recruitment and retention facilitators were similar across settings and included contacts\/reminders, community engagement, and relationship\u2010building, consideration of participant logistics, and incentives. Inadequate staff and resources were commonly cited recruitment and retention barriers. Few studies have rigorously examined optimal ways to recruit and retain rural participants in pediatric clinical trials. 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