Obesity prevention interventions targeting the built environment are an emerging area of research, but few studies have been applied in rural communities or among preschool-aged children, despite being high-priority populations. This study aimed to identify barriers to accessing nutritious foods and physical activity opportunities from the perspectives of parents of preschoolers living in low-income, rural communities. A mixed methods study design guided by a social ecological model incorporated quantitative surveys and qualitative interviews to gain a comprehensive understanding of the rural built environment. Results indicate proximity to recreation spaces, traffic safety, availability of public indoor space, and the consumer food environment are influential in utilization of resources and possible areas of improvement. However, interventions should be tailored to the community’s stage of readiness, evidenced by the theme “cognitive reactions to barriers.” Strong social networks in rural communities should be considered an asset for community change in these regions.