Italians arrived in massive numbers in the early 1900s, with over 17,000 settling in the state by 1910, mostly from southern Italy. Many worked as coal miners and were known for their hard work and impressive feats. Italians also worked in various trades, namely stone masonry, and businesses, particularly in northern West Virginia.

While some have left, many have stayed and contributed to labor movements, Catholic communities, and local culture, including Italian festivals. By the third generation, Italians were involved in politics, with Joe Manchin becoming the state's first governor of Italian descent in 2005.