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The U.S. airline industry underwent significant changes throughout the last decade. Airlines incurred losses in the late 2000s as a result, in part, of the economic recession and historically high jet fuel prices. Since 2014, the airline industry has become profitable with the economic expansion and low jet fuel prices, congressional concerns persist regarding the availability of airline service to smaller communities. These changes in airline industry conditions warrant an examination of industry trends and their implications for service to small- and medium-sized airports. We are initiating this review to (1) detail recent aviation industry trends, particularly as they relate to service to small and medium-sized communities and (2) provide a descriptive analysis of factors associated with changes in airline service to small and medium-sized communities.