Regional policies intended to reduce geographical inequalities in economic prosperity and performance across the UK date back to 1928. Yet, today, the UK has one of the highest levels of spatial economic inequality of any of the OECD nations. Many of today’s lagging regions and cities are the same as in the 1920s and 1930s, and these have been joined by other economically disadvantaged areas. This raises the key question as to why past regional policies have had such limited lasting impact. This collection of interrogative essays, by experts in their respective fields, examines past policies to identify both their positive and the negative aspects with a view to explaining that question. Several recurring weaknesses of past policies are identified (including inadequate resources, excessive churn of policies, a lack of strategic vision, inadequate embeddedness into mainstream policymaking, and a disproportionate concentration of economic, financial, and political power in London). Whilst recent major policy initiatives, including levelling up, an industrial strategy, and devolution, go some way to addressing the limitations of past policy, whether they are likely to achieve a more spatially balanced economy at what is a critical time for the UK’s national economy is debatable. This book will be of value to students, researchers, and policymakers in the fields of regional and urban development.