Background: The incidence of burns in the world varies. Deaths from burns in poor and developing countries are estimated to be seven times higher than in developed countries. Case: We will report cases of burn injury in Sumenep, East Java which located in the eastern part of Madura Island. The first patient found to have superficial partial and deep dermal thickness burn, with a total burn area of 90% TBSA, while the second patient was a child and found to have 64% TBSA. Treatment was based on ABA algorithm. Discussion: Rural burns were frequent and severe, which demonstrate the importance of appropriate prevention directed at rural populations, educational programs, and regulations concerning the restricted use of combustible fluids and hot water in individual homes should be developed. Lack of parental education, poverty, large families, substandard housing, and delayed admission are all associated with increased risk of burns in rural areas.