Rural residency programs in medical education aim to prepare students for healthcare in underserved areas by enhancing their clinical skills, research capabilities, and teamwork. This cross-sectional study explores medical students' perceptions of rural residency at Al-Neelain University in Sudan. Data were collected through questionnaires administered to 110 students and interviews with experts. Findings indicate that rural residency improved students' knowledge, skills, and empathy towards rural health. However, challenges such as cost and faculty engagement were noted. Recommendations include increased funding, integration of rural residency into curricula, and further research to optimize program impact.