The author reflects upon regional economic change and the ways in which this is conceptualised and understood, drawing heavily but not exclusively on some thirty years of research on economy, politics and society in the North East of England. The principal question that this paper addresses is: how are the long periods of continuity, punctuated by occasional major shifts in developmental trajectory and the region's place in the global economy, to be understood? The author seeks to answer this question by exploring the extent to which continuity and change in the region's developmental trajectory can be understood in terms of evolutionary and institutional concepts and the varying engagement of the state with issues of socioeconomic development and change. The value of theoretical plurality in seeking to understand uneven development in capitalism is demonstrated and the limits to public policies that seek to address regional problems indicated.