Background: Compared to the urban population, pts in rural areas face healthcare disparities and experience inferior healthcare-related outcomes. Herein we aimed to compare the health care quality metrics and outcomes between pts with aPC from rural versus urban areas treated at a tertiary cancer hospital. Methods: In this IRB approved retrospective study, eligibility criteria were: presence of aPC, treatment at a single center (NCI-Designated Comprehensive Cancer Center (NCI-CCC), between 10/2017 to 9/2021). Rural-urban commuting area (RUCA) codes from the 2010 census /were used to classify the pts’ residences as urban (1-3) or rural (4-10) areas. The straight-line to distance of the pts’ place of residence from our institute was also calculated and included in the analysis. The median household income data were obtained and calculated from “The Michigan Population Studies Center”, based on individual zip codes. Results: A total of 994 pts were eligible and included (83.9% urban vs 16.1% rural). The baseline demographic profile and tumor characteristics were similar between the two groups. The median household income of pts from urban areas was higher by $8604/annum than that from rural areas (p<0.0001). There was no difference between urban versus rural pts in terms of receipt of lines of systemic therapies, clinical trial accrual, and receipt of tumor genomic profiling. No significant difference was found in the median overall survival between the two population (83.7 versus 92.8 months; p=0.14). Conclusions: These hypothesis generating data show that access to quality care, as available in an NCI-CCC can mitigate the disparities in the quality of health care delivery and clinical outcomes in urban versus rural pts with aPC.