Objective: Like their urban counterparts, rural populations are experiencing increased health risks due to chronic disease. However, disease management is more problematic due to isolation, increased difficulty in getting to medical appointments, and reduced numbers of medical personnel. We undertook a pilot study to investigate the feasibility and utility of health coaching for rural residents with type 2 diabetes mellitus (DM2) from a local pharmacy. Methods: Using the pharmacy database to identify qualified individuals, a nursing student recruited four individuals aged 40 - 79, with a history of DM2 of 3 - 15 years, to participate in the pilot project. Individual in-person interviews were conducted to identify specific goals to effectively self-manage their condition and to rate their confidence in their ability to fulfill these goals. Three monthly sessions were held to review and update goals, and to record blood pressure, waist circumference and weight measurements. Results: At the end of the study, all four achieved success in reaching and maintaining their personal dietary and physical activity goals. Significantly, all participants expressed increased confidence in their ability to self-manage their diabetes after health coaching. Conclusion: The provision of health coaching services from local pharmacies has potential to support rural clients in chronic disease management in medically under-serviced rural areas.