We all know that big cities in the U.S. would probably be targeted; like Los Angeles, New York City, and Washington D.C. But what would Rural America be like? I'm guessing some of the radiation would've reached it, and it would be affected by the weather changes a nuclear war causes. But wouldn't all the structures still be intact, making it more suitable to live? I'm not sure about this, so I came here for questions. So what would it be like?

It comes down to the nature of the launch, if all the launches are assumed to be authorised and tactical, then you'd expect the greater points of interest to take a heavier hit. Though these locations would have likely employed more solid counter measures to combat this, and so the ratio of damage would still be reduced even though those areas would arguably have recieved greater punishment. Leaving rural areas to deal with anything and everything that came their way. Less rural areas were left quite intact, Reno being a fair example. But this all assumes that the nuclear exchange was a tacticaly human affair. Yet their could have been a number of overriding scenarios that threw tactical logic out the door.

I imagine it would be nothing special, compared to the rest of the wasteland you'd have a group of survivalists with a load of shotguns and brahmin, and inbreeding. Ignoring the latter, it's not such a noteworthy comparison.

Remember that the name of the game is Fallout. Just because a place didn't get directly nuked doesn't mean that it is still intact. The reason you're supposed to be worried about nuclear fallout is because it just plain poisons everything. Hence the irradiated water, the dead trees, et cetera.

So rural areas will be just as devestated as metropolitan ones, just in a different way.

This. Fallout is the radiation given off from the bomb when it explodes, it poisons the water, the animals the tree's, and more importantly, you.
The Survivors from Nagasaki were very sick after the bomb due to Fallout and many died, which is why im suprised there isn't any deformities with charecter's in Fallout 3 because it effects people in Japan today.

Yees but in Fallout people don't die of lukemia and cancer due to radiation exposure. They either die of 'radiation poisoning' (which in Fallout seems to be a threshold of Rad intake), or they ghoulify (after a slower, longer method of exposure). In Fallout, considering the scenario, the most devastation would have been suffered during the great cleansing, if rural areas weren't hit that hard, or at all, they would have at least had the time to take an initiative before the fallout started touching down from the atmosphere, and then it would have been a matter of years (or even months) before most of the lethal rads would have died out. The same generation would have at least been able to try and rebuild after the great war, much like the Hub just 16 years after the great war, and most control Vaults were scheduled to open roughly 10 years after the great war.