The OECD territorial review of Småland-Blekinge presents an overview of recent trends, regional policies and governance arrangements of this region that is made up of four counties in South-East Sweden: Jönköping, Kronoberg, Kalmar and Blekinge. The challenges include the need to facilitate a shift from the region’s historic specialisation in medium-low and low technology manufacturing towards more knowledge-intensive activities. This will require addressing the supply of human capital, improving connectivity and enhancing the attractiveness of the region. A regionalisation reform is now under discussion in Sweden with potential implications for Småland-Blekinge. Whatever the future administrative structure of Småland-Blekinge, the effectiveness of regional development policies and public service delivery will be directly related to strengthened interaction and co-ordination arrangements among the numerous actors and administrative units involved.