This study examined the relationship between demographic factors and other correlates of fatalism, and assessed the impact of fatalistic beliefs on the participation in breast cancer screening in rural women. The subjects were 220 women aged 50 and over recruited from 6 large rural counties in South Carolina. Data were collected using a demographic questionnaire and the revised Powe Fatalism Inventory. Results show significant associations between fatalism and increased age (p = 0.005), race (p = 0.0001), doctor recommendation (p = .0034) and decreased educational level (p = 0.001). Fatalism was associated with noncompliance with mammography screening in univariate analysis among African-American women (OR = .362; 95% CI: 1.11, 11.8). After adjusting for possible confounders (age, education, and doctor recommendation), fatalism was not significantly associated with noncompliance with screening. These results illustrate age, race, and education may be important predictors of fatalism and that fatalism may be one barrier that has previously gone unmeasured and unchallenged in understanding screening behavior in older women.