During his tenure as Speaker, he worked to transfer state funds to the often-neglected western mountain counties of North Carolina, building roads and other public facilities that would not have existed otherwise.

A major accomplishment of his time as Speaker was the creation of the Liston B. Ramsey Activity Center at Western Carolina University.

The Center, opened in 1986, features facilities for basketball, volleyball, and other sports, as well as sponsoring cultural activities on the Western Carolina campus.

In January 1989, Ramsey was ousted as Speaker of the House when Republican Governor Jim Martin secretly joined his party's forces with 20 Democratic state representatives led by Joe Mavretic.

The Center houses Ramsey's official papers from his years in public office, and is dedicated to preserving the heritage and culture of the people of the Southern Appalachian Mountains.