Context: Disparities in cardiovascular health between individuals in rural versus urban areas are well documented. Cancer survivors are at increased risk of cardiovascular disease. Current data is limited on the cardiovascular risk profiles for cancer survivors for rural versus urban residence, hindering the development of risk reduction strategies. Objective: Compare cardiovascular risk profiles for cancer survivors in urban versus rural counties in South Carolina, a rural state with a high rate of cardiovascular disease. Study Design: Cross-sectional study Setting: Academic primary care. Population studied: Cancer survivors referred to primary care. Outcome Measures: Ten- year atherosclerotic cardiovascular disease risk (ASCVD) calculated based the American College of Cardiology/American Heart Association algorithm. Differences in prevalence of hypertension, hyperlipidemia, diabetes, blood pressure control, body mass index, physical activity and social determinants of health, stratified by urban or rural residence based on the Center for Disease Control classification. Preliminary Results: Demographics between rural and cancer survivors were not significantly different. Rural cancer survivors (n=15, 21.4%) were on average 55.5 (SD 8.8) years old, African American (53.3%), female (60.0%) with a mean BMI of 27.6 (SD 7.4). Urban cancer survivors (n=55, 78.6%) were on average 59.4 (SD 9.5) years old, White (69.1%), female (67.3%) with a mean BMI of 28.3 (SD 8.5). Those residing in rural counties had a higher incidence of hypertension compared with those in urban counties (73.3% vs. 32.7%, p<0.01, N=70) as determined by Fisher’s exact test. There were no significant differences in diabetes (50% controlled for both groups, N=12), hyperlipidemia (33.3% in rural vs, 23.6%, N=70) or blood pressure control (60.0% controlled in rural vs. 70.4%, N=69). Ten-year ASCVD risk was 15.1% in rural counties compared with 9.6% in urban counties. Conclusion: As this study progresses, the sample size will be increased, and may lead to more differences between rural and urban populations emerging. Data on physical activity, and social determinants of health, such as employment status and indicators of financial strain, as well as additional multivariate analyses, will better describe the underlying factors potentially associated with increased cardiovascular risks for cancer survivors in urban versus rural counties of South Carolina.