South Dakota is facing a unique transformational opportunity in its history. A perfect storm of events has presented itself that could catapult the state into international recognition and turn a rural region that is currently losing population into a vibrant state that offers new opportunities to its existing citizens and to those who want to return to the state or make South Dakota their new home. This report discusses research conducted in 2007 in six communities in the East River region of South Dakota and offers suggestions for how the region can take advantage of the unique opportunities that have presented themselves.