During the 20th century, the Greater Stockholm area emerged, as an integrated labour and housing market, increasing the need for regional coordination.

A proposal for a "Greater County Council" (storlandsting) was introduced.

In 1966, the Municipal Association for Regional Affairs of Stockholm City and County (Kommunalförbundet för Stockholms stads och läns regionala frågor) was established.

[1] Region Stockholm manages and operates:[2][3] Region Stockholm is also involved in medical research and education in collaboration with local universities, particularly Karolinska Institute.

Region Stockholm oversees public transport in the county through its companies SL and Waxholmsbolaget.