In low- and middle-income countries, gender norms and access to energy-dense, nutrient-poor foods are well-studied determinants of food and physical activity choices for adolescent girls. However, most work has been done in urban and school settings. In many settings, a large proportion of the adolescent population is rural or not enrolled in school. We conducted in-depth interviews with 20 adolescent girls (ages 15-19) in Tecpán, Guatemala, a rural, largely indigenous Maya community. Interviews were coded and themes analyzed for insights into eating habits, food choices, and physical activity. Twelve participants were enrolled in school and eight were employed and not in school. Girls enrolled in school had more disrupted eating schedules and consumed more energy-dense, nutrient-poor foods. Girls not enrolled in school had fewer opportunities for physical activity and were more sedentary. To our knowledge, this study is the first in a low- and middle-income country to consider diet and physical activity of adolescent girls enrolled and not enrolled in school. Key implications include (1) the need to reduce exposure to nutrient-poor foods and promote healthy eating schedules in schools, and (2) the need to create community-based opportunities for the activity for girls no longer enrolled in school.