TechGROWTH Ohio (TGO) is a public, rural venture development organization serving the 20 counties of Southeast Ohio. From 2007 to 2016, TGO engaged with over 1300 entrepreneurs, assisted over 1100 startups, provided funding support to over 90 companies and invested in 14 portfolio companies. This sustained eort resulted in over $350M of non-State follow-on resources acquired in support of client companies and the creation of over 575 direct jobs in the region with an average salary of $53,750 in a region where median household income is $33,823. TGO has achieved a leverage ratio of $17.8 for every $1 of State spending. This paper places TGO in the context of best practices in public venture capital and entrepreneurship support in rural America. It also highlights both short-run and long-run impact at the company and regional ecosystem level.