From the founding of the state to the present, most West Virginia women have lived in rural areas, a reality with many implications for their social and economic lives. In early years, most women lived on farms. Farm life involved separate but complementary roles for women and men. Women's contributions in gardening, tending chickens and small livestock, and the many activities of domestic production (spinning, sewing, weaving, canning, and so forth) were essential within the cash-poor economy of most farm households. In addition, women cared for the house and children, prepared the food which they had helped to produce, and provided home health care as needed.

Rapid industrialization during the last two decades of the 19th century dramatically altered many women's lives. Jobs in railroading, timbering, and coal mining drew men out of agriculture and into industrial work. Racial and ethnic diversity among women increased, as Black migrants from the Deep South and immigrants from southern and eastern Europe came to West Virginia in search of the new jobs. For rural women, however, the employment opportunities were few. Unlike certain other Appalachian states, where the extensive development of textile mills offered jobs to both women and men, with some exceptions industrialization in West Virginia tended to lock women out of the paid labor force. But even as women increasingly relied on male wages to survive, so men depended on women's domestic labor to turn their wages into consumable products such as food and clothing.

Women from more affluent families sometimes achieved a measure of economic independence through professional employment. White women whose families were willing and able to support their education could attend the female seminaries and institutes that first developed during the 1830s in Western Virginia. In 1867, the West Virginia legislature authorized the establishment of normal schools to train teachers, including a school for African Americans at Harpers Ferry. Educated women of all races saw their employment opportunities as nurses and teachers grow with the state's expanding population. However, they were often forced to choose between marriage and employment: in a majority of school districts, female teachers who married were required to resign their positions, a practice that persisted until World War II. Moreover, until the last decades of the 20th century women faced severe discrimination in more prestigious and lucrative professions such as law and medicine.

Despite these and other disadvantages, including lack of voting rights until 1920, many women in West Virginia were active political organizers who pressed for change in their workplaces, civic life, and other arenas. Working-class women joined labor unions, such as the International Ladies' Garment Workers Union, or provided organized support to men's union activities. More affluent women established local chapters of the Women's Christian Temperance Union and pressed for prison reform and women's suffrage as well as prohibition. In more recent years, women participated in groups such as the national Coal Employment Project and Women and Employment, which advocated for women's access to higher wage jobs in industries such as coal mining.

Today, women in West Virginia face many of the same obstacles, opportunities, and domestic responsibilities as women in other states. Some have benefited from the expansion of professional service employment (for example, in health and education) and the widening range of professions open to women, but many lack the education required to pursue such opportunities. Only 22 percent of West Virginia women aged 25 and over have attained a bachelor's degree or higher, compared to 39 percent of women across the United States. While West Virginia's rate has increased from only 14 percent earlier in the 21st century, the state still ranks last in the nation in this category. Women without higher education or technical training do experience expanded employment options, especially in the service sector, but these jobs typically offer low wages and few benefits.

In their domestic lives, West Virginia women also experience many of the same trends as women across the nation. These include a rise in female-headed families (15.3 percent of families in the state are headed by women, as compared to 15.9 percent in the U.S.), and the responsibility of caring simultaneously for older family members and younger children. The latter trend is especially prominent in West Virginia, which has the highest rate of disability of any state as well as the highest median population age. Increasingly, women are elderly themselves or care for elderly relatives even as they also care for younger family members. The majority of the state's women continue to live in rural areas where many support themselves and their families through creative subsistence strategies outside the formal labor market.