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This dissertation analyzes the environmental history of Pendleton and Randolph Counties, West Virginia, as it relates to underdevelopment within the broader Appalachian region. Theories of political ecology and reconstructed regional geography are used to gain a better understanding of the intersection between cultural practice and human use of the natural environment. Specifically, three case study locales are utilized in this study to demonstrate local variability in natural resource issues within the Appalachian region. Political ecology and reconstructed regional geography are integrated to create a conceptually and contextually refined 'regional' political ecology which accounts for issues of geographic scale and alternative epistemologies of nature. Through secondary sources, and primary data gathered through the collection of oral testimonies, it is found that the environmental history and the struggle for the control of productive resources in the three locales has produced conflicting epistemologies of nature which directly impacts local people's ownership, use of, and access to the natural environment. This supports the argument that understanding conflicting epistemologies of nature, at multiple geographic scales, is fundamental to a more comprehensive account of underdevelopment as an historical process. The analysis leads to the conclusion that conflicting epistemologies of nature represent alternative ways of attempting to produce nature. At a more fundamental level, this analysis concludes that reconstructing the regional geography of Appalachia necessarily involves addressing human-nature interaction. It is demonstrated that regional transformation is both a human and physical process, where various cultural, political, and economic systems are simultaneously interacting to produce patterns of uneven development.