Large and great earthquakes have rupture lengths from about 50 to 1000 km. With several meters of slip, they wreak great damage in all settlements along their ruptures. The distances to which casualties are reported range from 0 to 40 or 50 km in countries with poor construction of the built environment, that is, in developing countries. Small rural settlements with housing of inferior strength, which are strongly affected, thus number in the thousands in great earthquakes, whereas only one to a few major settlements are located close to the rupture. For this reason, in most great earthquakes 80% to 100% of those killed are from rural settlements, not from cities. Therefore, the focus of earthquake mitigation needs to be changed from urban centers to rural areas near active faults.