Many small and midsized cities in America are making efforts to revitalize their downtowns. However, the evaluation of their revitalization efforts has not been given much attention unlike larger urban communities. The objective of this paper is to identify successful small and midsized cities, explore the reasons for their success, and draw lessons that can aid less successful downtowns within this size. 16 cities were selected as case studies from the four US Census regions with a focus on their history and downtown revitalization process. The evaluation is addressed from socio-economic perspectives, and a comparative analysis of some key indicators of evaluating successful revitalization efforts. The result showed that, no downtown is the same in structure or problems faced but there is an opportunity for these smaller and midsized cities to learn from each other and adopt successful approaches used in other cities to help rejuvenate their own downtowns.