Greeks entered West Virginia in significant numbers around the turn of the 20th century. The Turkish government had begun drafting Greeks living in areas under Turkish control into the Turkish Army to fight against their Greek countrymen. Many fled overseas, just at the time that West Virginia faced a labor shortage due to increased mining and manufacturing. The first Greeks to arrive were generally single men or married men who came alone. After getting settled, they would send for their families.

For example, in the first decade of the 20th century, around 300 Greeks settled in Harrison County to work at the Phillips Sheet and Tin Plate Company, known as the "Tin-plate" factory, owned by Weirton Steel. Greeks also worked in the iron and steel centers of Wheeling and Weirton and in many coal mines around the state. The 1910 census lists 787 foreign-born Greeks living in West Virginia. The 1920 census shows that the number of Greeks had grown to 3,186, with the majority in Harrison, Hancock, and Ohio counties. Though initially working in West Virginia's coal and manufacturing industries, many Greeks gravitated toward retail, such as restaurants, theaters, coffeehouses, and grocery stores. These were independent business people, doing the type of work they were accustomed to in Greece.

Greeks in West Virginia, as elsewhere, formed kinotitoes, governing bodies of local Greek communities, which would establish Orthodox churches and schools. Following a Greek custom, many immigrants opened kaffeneions (coffeehouses) in their homes, perpetuating Greek customs here. Greek holidays (particularly March 28, Greek Independence Day) were often celebrated with parades with many people dressed in the traditional clothing of Greece. After World War I, immigration from Europe declined and Greeks, as with many other ethnic groups, began to move away from their close-knit communities and into other West Virginia towns, working in diverse professions.