In most developing countries across the world, cellular rural users are predominantly pedestrian and indoor users within village homes, and much less from vehicles, let alone fast-moving ones. Specifically, in India, 85% of the villages in the plains are spaced 2–3 km apart uniformly in every direction. The base station required for providing coverage in rural areas is starkly different from the base station along highways to provide coverage for fast-moving vehicles. Till IMT-2020, ITU did not have a rural use case suited to rural needs of developing countries. Hence, the IMT advanced technology development (such as 4G LTE) did not meet the rural requirements in countries like India. To avoid such a situation for 5G, a new test case requirement, named low-mobility large cell (LMLC) was included as a mandatory use case with performance requirements that must be met by every specification that is approved as an IMT-2020 compliant standard. In this paper, we describe the reasons why such a test case requirement is crucial by taking a case study from the Indian rural setting. In addition, we also describe various technical solutions that can be considered to satisfy such stringent requirements. In particular, we look at a new waveform with low peak-to-average power ratio that has been introduced in 5G for coverage enhancement.