Contact with nature is associated with numerous psychological, physiological and social health and well-being benefits. Outdoor recreation, such as rural second home tourism, provides extensive exposure to the natural environment, but research around health impacts of this exposure is scattered. We review current research on health and well-being impacts of nature and discuss how the characteristics of rural second home environments and their use and users can affect these potential impacts in Finland. We discover four key issues affecting the impacts. First, health and well-being impacts depend on the users; urban people can especially benefit from rural second homes, while child development and the performance of elderly people can also be supported by contact with nature at second homes. Second, the regularity, length and season of second home visits influence the potential to receive benefits as they have an impact on the intensity of nature exposure. Third, the type and quality of second home environment affect contact with nature, such as exposure to health-supporting environmental microbes. Fourth, practices, motives and meanings modify activities and attachment and crucially affect both physical and mental well-being. We conclude that rural second homes have extensive potential to provide nature-related health and well-being benefits and further research is needed.