The Middlewest Region was organized in 1956 and includes the states of Indiana, Iowa, Kansas, Michigan, Minnesota, Illinois, Missouri, Nebraska, North Dakota, South Dakota, Ohio and Wisconsin. There are chapters in five of the twelve states in the region. There are a total of seventeen graduate and undergraduate chapters in the region with over 320 active members.

The Regional History was compiled and published by Soror Lillian Stokes, RN, PhD  in 1999. The first and second Directors of the Middlewest Region are honored through the  regional scholarship named the "Ella Rose Carter Scholarship" for the First Regional Director and the annual luncheon named the "Gladys Manzo Pathfinder Luncheon" for the second director. Regional meetings convene annually, hosted by chapters within the region.

The Middlewest Region objectives are:

• To increase visibility within the community.
• To foster a continuous recruitment program for nursing and the health profession.
• To maintain a close and friendly relationship among the members.
• To collaborate with other professionals groups for the improvement and delivery of health care services.
• To develop a corps of nursing leaders within the membership who will function as agents of social change on the national, regional, and local level.

Diana Brown-Brumfield MSN, RN, CNS is the current director of the Middlewest Region (2006-2008). Diana joined the sorority in 1991 and is a member of Nu Chi Chapter in Cleveland, Ohio. Diana is currently employed at Cleveland Clinic Foundation as the Perioperative Clinical Nurse Specialist in the Department of Surgical Services.