This Note to the Coalitions focuses on an approach to energy generation and distribution that could help move forward revitalization of the Northeast-Midwest region’s many older industrial cities. Specifically, district energy and combined heat and power (DE/CHP) systems offer a potential source of competitive advantage to older cities in the form of cost-savings, energy reliability, and a reduced carbon footprint. However, those wishing to develop DE/CHP face often inadvertent utility-related, financial, and policy obstacles. This Note explains the opportunities that DE/CHP can afford older cities and describes the policy context surrounding DE/CHP development; a case example of the Medical Center Company of Cleveland, OH, provides a real-world illustration. The Note concludes with a policy agenda for faster realization of DE/CHP, and its benefits, in the region’s older industrial cities.