The Mountain State Press was founded by Jim Comstock, the colorful publisher of the West Virginia Hillbilly weekly newspaper. Comstock recruited a young Marshall University graduate, Peter Wallace, to help with this new venture, and in February 1978 Comstock and Wallace became the incorporators of Mountain State Press. The articles of incorporation stated that the purposes of the press were to promote and publish books by West Virginians and books "which support and reinforce the values, priorities, and culture of West Virginia." Approximately 400 people became contributing members, paying dues to support the press and receiving books and discounts in return.

The press is managed by a board of directors. Professor William Plumley of the University of Charleston served as the first president of the press. The first book published was As I Remember It, reminiscences by Stanley Eskew. A reprint of W. E. R. Byrne's classic Tale of the Elk soon followed. Mountain State Press has published more than 50 books. Authors represent all areas of the state and a wide range of subject matter. Since shortly after its inception, Mountain State Press has been located at the University of Charleston.