Critical Access Hospitals (CAHs) have experienced significant shifts in revenue sources and patient volume over the past decade, changes that may affect long‑term financial sustainability and service availability. This study examines trends in inpatient and outpatient revenue and volume among CAHs from 2017 to 2024 using cost report data from the Centers for Medicare & Medicaid Services. The sample includes 1,145 CAHs with complete annual data, with revenues adjusted to 2024 dollars. Results indicate a continued decline in inpatient revenue and average daily census, alongside substantial growth in outpatient revenue. Outpatient services accounted for an increasing share of total patient revenue, rising from 76.0% in 2017 to 82.3% in 2024. These trends were generally consistent across hospital rurality, region, ownership, and system affiliation. Findings suggest that growth in outpatient care has enabled many CAHs to maintain relatively stable inpatient capacity despite declining inpatient utilization. As public health emergency funding has ended, understanding these trends is critical for policymakers and State Flex Programs seeking to support CAH sustainability and guide strategic planning in a post‑pandemic environment.