Although coal production has declined, the region has diversified into education, healthcare, energy, and outdoor tourism. Colleges, regional hospitals, and cultural initiatives now support long-term stability. The area remains one of the most culturally distinct parts of Virginia, with strong traditions in music, crafts, and community life.
This region is less densely populated than others but offers dramatic landscapes and tight-knit towns. It attracts visitors interested in Appalachian heritage and residents who value community connection and mountain living.
| City | Population | County |
|---|---|---|
| Abingdon | 8,200 | Washington County |
| Big Stone Gap | 5,000 | Wise County |
| Blacksburg | 45,000 | Montgomery County |
| Bluefield | 4,800 | Tazewell County |
| Bristol | 17,200 | Independent city |
| Clintwood | 1,300 | Dickenson County |
| Coeburn | 2,100 | Wise County |
| Dublin | 2,600 | Pulaski County |
| Gate City | 2,300 | Scott County |
| Grundy | 900 | Buchanan County |
| Lebanon | 3,600 | Russell County |
| Marion | 6,000 | Smyth County |
| Narrows | 2,000 | Giles County |
| Norton | 3,700 | Independent city |
| Pearisburg | 2,800 | Giles County |
| Pennington Gap | 2,100 | Lee County |
| Pulaski | 9,000 | Pulaski County |
| Radford | 17,300 | Independent city |
| Richlands | 5,300 | Tazewell County |
| Stuart | 1,400 | Patrick County |
| Tazewell | 4,400 | Tazewell County |
| Wise | 3,100 | Wise County |