Rural and urban transportation needs are known to be different. Our objective was to understand how infrastructure investments could help rural areas of North Carolina with economic development. For many planners and economic developers, freight growth is seen as the physical manifestation of a strong economy but planning for freight is challenging. For us to understand the rural needs better, we conducted a socio-economic study, an economic analysis, and two workshops. The workshops focused on two areas of the state, the deep southwest and the far northeast. These regions are among the most economically depressed and economic development through enhanced freight infrastructure could be very helpful. Due to the mountainous terrain in the deep southwest, the resiliency and reliability of the state’s transportation system is critical. Even more important than building new capacity, is ensuring the functionality of existing highway, rail, and aviation assets. The region does not act as one unit, but instead as a collection of many microeconomies that transcend county and state boundaries. The proximity of the far northeast to Norfolk and the eastern seaboard provides a comparative advantage for marine industries. The area is well-positioned to capitalize on economic growth related to a nearby metropolitan area in Virginia. Highway, waterway, and other transportation networks that connect the region’s business and population centers to the Norfolk region can facilitate economic growth.