Interest in the study of rural tourism and its contribution to the development of rural mountain communities has increased in recent decades. It is recognized that many factors are involved in tourism development, and that residents play a key role in ensuring its success at a local level. This study aims to investigate the perceptions of the inhabitants of the mountainous rural area in the North-East Region of Romania (MRA) towards rural tourism, and to verify whether the development of entrepreneurship in this area is consistent with the positive/negative perceptions identified. A total of 1277 questionnaires were collected from the inhabitants of 78 sampled municipalities, and their processing using statistical methods shows that the inhabitants of two counties have positive perceptions of the living conditions in their communities, the involvement of the authorities in the development of tourism, and the exploitation of tourist attractions. On the other hand, comparing the values of entrepreneurship development indicators shows that two counties concentrate 91% of all active businesses and 94% of newly created businesses in the food and accommodation sector at the level of the study area, and the rate of creation of new businesses and their density have much higher values in these counties than in the county where the analyzed aspects are perceived negatively. The information provided by the research is particularly useful for regional and local authorities to make decisions related to more consistent funding of rural mountain tourism.