Carilion Giles Community Hospital in Pearisburg is a 25-bed Critical Access hospital offering general medical services including emergency care, high-quality inpatient care, and an extended care recovery program. Carilion Clinic Family Medicine also located in Pearisburg, provides services including acute care, physical exams, well visits, and immunizations to Giles County residents.

Heritage Hall-Rich Creek is a 44-bed nursing home in Giles County that provides long-term care to elderly residents.

Twenty-two physicians and seven dentists practice in the county.

The county has two independent public library systems in Pearisburg and Narrows with a combined collection of over 86,000 volumes. Area residents can also utilize the library facilities at Virginia Tech in Blacksburg and nearby Radford University.

Giles County has over 70 places of worship representing most Protestant denominations and the Roman Catholic faith. A Jewish synagogue is located approximately 25 miles away in Bluefield.

A variety of shopping opportunities are available to area residents. Approximately 200 retail outlets are dispersed throughout the county. A broad mix of retail establishments can be found in the downtown areas of Pearisburg, Narrows, Rich Creek and Pembroke, and in the two shopping centers located in the county.