Population aging is being experienced by many rural communities in the U.S., as evidenced by increases in the median age and the high incidence of natural population decrease. The implications of these changes in population structure for the daily lives of the residents in such communities have received little attention. We address this issue in the current study by examining the relationship between population aging and the availability of service-providing establishments in the rural U.S. between 1990 and 2010. Using data mainly from the U.S. Census Bureau and the Bureau of Labor Statistics, we estimate a series of fixed-effects regression models to identify the relationship between median age and establishment counts net of changes in overall population and other factors. We find a significant, but non-linear relationship between county median age and the total number of service-providing establishments, and counts of most specific types of services. We find a positive effect of total population size across all of our models. This total population effect is consistent with other research, but the independent effects of age structure that we observe represent a novel finding and suggest that age structure is a salient factor in local rural development and community wellbeing.