Switzerland is an innovation leader, with a long history of federalism, regional collaboration and bottom-up consensus-building. While several regions in Switzerland are top international performers in innovation, rural regions are on average lagging behind. This underlines the importance of understanding innovation through a rural lens and providing support to entrepreneurs, firms and innovators across rural regions. This chapter sets the scene for the report. It outlines the structure of rural regions, discusses trends in innovation across all types of regions, and identifies challenges in promoting well-being and adapting to changing societies.