On January 23, 1890, rival miners' organizations met in Columbus, Ohio, to organize the United Mine Workers of America. Founded two days later, John B. Rae, a Scottish immigrant, became the first president. Just three months later, in Wheeling, UMWA District 17, encompassing most of West Virginia, held its first meeting, elected M. F. Moran as district president and immediately launched what became an extraordinary struggle of more than 40 years to unionize the state's coal mines.

In 1897, alarmed at the rising tonnage flooding into their markets from nonunion West Virginia, the coal operators of the Central Competitive Field of the North and Midwest agreed to an uneasy peace with the union but insisted that the UMWA also organize their Mountain State competitors. In its effort to fulfill that commitment, the UMWA faced no easy task. The rugged terrain left West Virginia miners isolated and dependent upon their employers. Miners and their families lived in company housing, traded at company stores, worshiped in churches built by the company, and received part of their pay in company scrip. Ethnic and racial differences in the coal camps inhibited labor unity.

West Virginia coal operators also provided hardy resistance. Insisting that because they relied on distant markets, they could not pay union wages and continue in business, they convinced political and judicial authorities and most of the state's daily press that their struggle against the union was a battle for the state's economic survival. To carry on the fight, coal operators organized associations and hired labor spies and heavily armed mine guards, many of whom carried the force of public authority as deputy sheriffs. Operators also fought on the legal front with yellow-dog contracts—individual employment agreements that prohibited workers from joining a union—and by obtaining injunctions against union activities.

In the face of these obstacles, the UMWA's repeated efforts in the 1890s and early in the 20th century brought few West Virginia miners into the union despite support from national labor leaders, Socialist Eugene Debs and noted organizer Mary Harris "Mother" Jones. In 1912, efforts to maintain a union toehold in the Paint Creek and Cabin Creek areas of Kanawha County led to a bloody confrontation.

During World War I, coal production expanded in West Virginia, and a tenuous labor-management truce prevailed as the federal government encouraged collective bargaining. When the fighting in Europe ended, however, the Mine Wars in West Virginia resumed, resulting in pitched battles in Mingo and Logan counties in 1919-21, including the Matewan Massacre, the March on Logan, and the Battle of Blair Mountain. Martial law, the intervention of federal troops, an investigation by a U.S. Senate committee, and the arrest of state UMWA leaders C. Frank Keeney and William Blizzard on charges of treason and murder, marked these conflicts.

Although prosecutors failed to convict Blizzard and Keeney, the labor battles and treason trials enfeebled the UMWA just as the industry faced a painful readjustment. Wartime expansion had generated a mining capacity that exceeded peacetime markets. The U.S. Coal Commission, established by Congress to study the problem, concluded that there were too many mines and too many miners. During the 1920s, West Virginia operators became more determined than ever that survival required nonunion operations. Membership in the UMWA plummeted. In 1924, District 17 President Keeney and Secretary-Treasurer Fred Mooney resigned as national president John L. Lewis attempted to impose an industry-approved pay scale in West Virginia. Increasingly autocratic, Lewis then made 17 a provisional district and split its territory, creating District 31 to administer most of northern West Virginia. He also crushed district autonomy by replacing elected officials with his own appointees in many districts.

During the Great Depression, the UMWA struggled to survive and briefly faced competition from the more radical West Virginia Mine Workers Union and the National Miners Union. With Roosevelt's New Deal, the legal climate improved. New federal legislation outlawed yellow-dog contracts, placed limits on anti-union injunctions, and gave employees the right to bargain collectively. The state outlawed the mine guard system. Urged on by Lewis and led by District 17 President Van Bittner, the UMWA finally unionized the West Virginia coalfields in 1933-34, making it not only the most powerful union in the state but also for many years a political force that could make and break politicians.

By the late 1930s, productivity, employment, and wages were rising. During World War II, the industry boomed and so did the UMWA in West Virginia. Bittner served as president of District 17 until 1942, when he resigned as a result of conflicts with Lewis. Lewis again divided 17, creating District 29 to administer the low-volatile fields of southern West Virginia.

Lewis aroused much public animosity by leading the union in wartime strikes which brought repeated federal takeovers of the mines but won a captive mines agreement and portal-to-portal pay. Post-war strikes resulted in the establishment of a welfare and retirement fund. The fund eventually paid medical and retirement benefits to millions of miners and their families and in the mid-1950s built ten miners hospitals in Southern Appalachia, including hospitals at Beckley, Man, and Williamson.

After World War II, the coal industry faced growing competition from other fuels. In 1950, Lewis moved from his confrontational methods and joined forces with industry leaders to promote rapid modernization of the mines, which increased productivity and wages but decreased the number of miners and shrank union rolls. Mine mechanization also contributed to the impoverishment of Appalachia, as unemployment spread through the region. A declining membership forced the union to cut welfare and retirement fund benefits and to close or sell its medical facilities.

In the 1960s, union leadership deteriorated with the rise to the presidency of William Anthony "Tony" Boyle, a long-time Lewis assistant. After a nine-year reign of corruption, Boyle faced a challenge from reformers. They seized the initiative in coal mine health and safety issues, persuaded the West Virginia legislature to pass a black lung compensation law, and lobbied for the federal Coal Mine Health and Safety Act of 1969. The reformers sought to topple Boyle in a 1969 election, but Boyle defeated Joseph A. "Jock" Yablonski. Three weeks later Yablonski, his wife, and daughter were murdered; Boyle was eventually convicted of plotting the crime. In 1972, the reformers, organized as Miners for Democracy, elected West Virginian Arnold Miller as president. Miller's presidency fell short of the high expectations of supporters. In 1979, the union turned to a more conservative course under President Sam Church Jr., who was in turn succeeded by Richard Trumka in 1982 and in 1995 by Cecil Roberts, a West Virginian whose family had deep roots in state labor history.

As the 20th century waned, the UMWA faced an uncertain future as ever more sophisticated technologies continued to increase productivity and to reduce the mine work force. When the Pittston Company tried to abrogate commitments to the welfare and retirement fund in 1989, affected miners in West Virginia and elsewhere launched a 10-month strike that succeeded in maintaining company payments to the fund but also brought attention to the troubling dilemma facing the industry and the union as the number of retirees continued to grow in the face of rising health costs and a declining work force. The federal Coal Act in 1992 strengthened guarantees for retiree benefits, and a long strike in 1993 eventually led to a broad national agreement between the union and the Bituminous Coal Operators Association. The union nevertheless remained concerned about job security, health and safety issues, and the benefit funds. The union also feared that legislation and judicial decisions dealing with environmental issues such as sulfur emissions and mountaintop removal could further reduce mining employment. Declining numbers of active miners also brought slippage in political influence, but with large numbers of pensioners and widows the union retained considerable clout in state politics.

District 29 was eliminated in 1996, leaving most of West Virginia under Districts 17 and 31. Robert Phalen presided over historic District 17 from 1985 until retiring in 2001. Joseph Carter was elected to lead the district, which was expanded to include Eastern Kentucky, Virginia and Tennessee, into the new century. As of 2024, District 17 was led by Brian Lacy, and District 31 was led by Mike Payton.