It is located 18 nautical miles [nmi] (33 km; 21 mi) east of downtown St. Louis and 14 nmi (26 km; 16 mi) east of the central business district of Belleville in St. Clair County, Illinois, United States.

It is a joint-use airport and is currently served by one scheduled commercial airline, Allegiant Air.

[5] Featured several times on a "Fleecing of America" segment on the NBC Nightly News, it was called a "Gateway to Nowhere" by Tom Brokaw, costing taxpayers $313 million.

[7][8] As of 2021, nearly $125 million of St. Clair County taxpayer funds have been spent covering the airport's deficits.

The airport's biggest revenue source is fuel sales to Boeing, which test-flies drones for the U.S. Navy.

[14] In late April 2019, the first MQ-25 Stingray test aircraft (T-1 or "Tail 1") was taken by road from Boeing's technical plant at St. Louis's Lambert International Airport across the Mississippi River to MidAmerica St. Louis Airport, which is conjoined to Scott Air Force Base.

[20] The civil operations are administered by St. Clair County, Illinois, which also pays the maintenance costs for the east runway.

[25][26] Both Boeing Defense, Space & Security and North Bay Produce currently have facilities on site.

North Bay Produce primarily ships blueberries from Michigan and Chile into the airport; they use a completely refrigerated warehouse for packaging and distribution.

[27][28] USDOT's most current data indicates 308,000 passengers used BLV between January 2018 and December 2018[3] and the airport was ranked 204th in the United States.

[33] By comparison, St. Louis Lambert International Airport was ranked 31 in the United States with over 6.21 million enplanements.

For the 12-month period ending December 31, 2020, the airport had 17,500 aircraft operations, an average of 48 per day: 57% military, 32% general aviation, and 11% scheduled commercial.

Additionally, MetroLink provides direct or indirect service to the Central West End, Clayton, Lambert Airport, and suburban areas in both Illinois and Missouri.