The development experience of the distressed counties is examined in this report through 19 case studies and an analysis of all distressed counties over a 15-year period. Distressed counties are those with poverty and unemployment rates that are more than 150 percent of the national rates and a per capita market income (i.e., per capita income less transfer payments) that is no more than two-thirds of the national average. The first section of the report presents case studies of 19 distressed counties that graduated from distressed status. The second part of the report examines the characteristics of all distressed counties for the period 1980–1994 to determine what factors contributed to their distressed status. The third part of the report develops an alternative distressed county index.