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Future climate change impacts on humans will be determined by the convergence of evolving physical climate and socioeconomic systems. Rural areas of the northeastern United States have experienced increased temperature and precipitation extremes, especially over the past three decades, and face unique challenges due to their physical isolation, natural-resource-dependent economies, and high poverty rates. To explore the impacts of future extreme events on vulnerable, rural populations in the Northeast, we analyzed future (2046-2075) annual maximum daily maximum temperature, annual minimum daily minimum temperature, annual maximum daily precipitation, and annual minimum two-week summer precipitation for two greenhouse gas emissions scenarios using four global climate models and gridded temperature and precipitation observations. We then combined those projections with estimates of county-level population and relative income for 2060 to calculate changes in extreme person-events compared to a historical period (1976-2005), with a focus on Northeast counties that are rural (less than 250,000 people) and vulnerable (in the bottom income quartile). For all counties and lowest income quartile counties in the rural Northeast, extreme heat person-events increase nineteen-fold and twenty-nine fold, respectively, under the high greenhouse gas emissions scenario, far exceeding the decrease in extreme cold person-events. The number of extreme precipitation and drought person-events does not significantly change across the rural Northeast. For the high greenhouse gas emissions scenario, counties in the bottom two income quartiles experience the 1976-2005 once-per-year daily heat event twenty-three times per year by 2046-2075; the lower greenhouse gas emissions scenario reduces the incidence to eleven times per year.