Regional differences in GDP per capita, productivity, employment and poverty in Lithuania are among the largest in the OECD, and they have increased over the last decade. The country still recovers from the legacy of the Soviet planning system which aimed at balanced geographical distribution of industrial activity and left many unviable firms and jobs across the country. Unemployment is high in many regions, while mobility of excess labour towards economically stronger areas remains insufficient. Some regions feature “surplus infrastructure”, while others lack investment. This chapter looks at potential reasons for persisting disparities and assesses recent policy initiatives to reduce imbalances. The digital infrastructure is weak in rural regions and should be strengthened to allow access to high-quality jobs in all parts of the country, including through teleworking. Housing supply in economically strong areas should be increased, while urban sprawl should be avoided. Stark gaps in education outcomes between rural and urban areas should be addressed, mainly by reorganising the municipal school network and by fostering firm-based learning (apprenticeships). Finally, municipal governments should be given more power, while the planned functional regions should help foster inter-municipal coordination.