Purpose The Purposes of this Study were to assess the level of foot self-care performed in a rural, multiethnic Population of older adults and to identify factors associated with foot self-care. Methods The Evaluating Long-term Diabetes Self-management Among-Elder Rural Adults Study included a random sample of 701 African American, Native American, and white adults from 2 rural North Carolina Counties. Participants completed in-home interviews, 5 foot self-care practices from the Summary of Diabetes Self-Care Activities (SDSCA), functional status measures, and measures of education and support for foot care. Results Foot care practices/behaviors reported at least 6 days/week ranged from 35.6% for inspecthig shoes to 79.2% for not soaking feet. Four independent predictors of the SDSCA summary foot care index score were observed: having been shown how to care for feet (P <.0001), female gender (P =.03), having had a doctor check nerves in feet in past year (P =.02), and not receiving support caring for feet (P =.0425). Conclusions These findings indicate that educating patients about foot self-care may encourage routine foot care but that those dependent on either formal or informal support to perforin foot care do so less frequently than those who perfored it independently.