This article examines the geographic distribution of funding for the U.S. Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) programs sponsored by the National Institute of General Medical Sciences (NIGMS). Despite a significant investment in SBIR/STTR and an interest in increasing geographic diversity in the institute's research portfolio, there has not been an assessment of the distribution of NIGMS's SBIR/STTR funding, outcomes associated with that investment, and relationships between the two. The geographic distribution of NIGMS' SBIR/STTR funding was highly concentrated in a small number of states, with a high correlation between each state's funding and its number of small scientific research and development businesses. Affiliation with a major research university was correlated with several measures of innovation and firm success. Our findings are consistent with earlier research showing that economic activity in research and development and research output tend to cluster in geographic regions where knowledge can be generated and shared more efficiently. These findings lend support to an investment strategy for small business research and development that creates networks between major research universities and small businesses.