| Year | Won | Margin | Democratic | Republican | Total |
|---|---|---|---|---|---|
| 2024 | R | 1,966 | 7,913 | 9,992 | |
| 2020 | R | 2,356 | 8,129 | 10,626 | |
| 2016 | R | 2,136 | 8,158 | 10,572 | |
| 2012 | R | 2,047 | 8,040 | 10,241 | |
| 2008 | R | 3,444 | 6,762 | 10,375 | |
| 2004 | R | 5,400 | 6,187 | 11,655 | |
| 2000 | D | 5,514 | 5,300 | 11,000 | |
| 1996 | D | 6,015 | 3,382 | 10,323 | |
| 1992 | D | 6,619 | 4,128 | 12,103 | |
| 1988 | D | 5,557 | 5,154 | 10,772 | |
| 1984 | D | 5,258 | 5,218 | 10,537 | |
| 1980 | D | 6,031 | 4,226 | 10,367 | |
| 1976 | D | 5,633 | 4,434 | 10,116 | |
| 1972 | R | 3,601 | 5,373 | 9,050 | |
| 1968 | D | 4,562 | 3,993 | 9,541 | |
| 1964 | D | 6,728 | 3,211 | 9,947 | |
| 1960 | R | 4,971 | 5,754 | 10,725 | |
| 1956 | R | 4,545 | 6,591 | 11,161 | |
| 1952 | D | 5,538 | 5,210 | 10,762 | |
| 1948 | D | 5,614 | 3,755 | 9,453 | |
| 1944 | D | 5,527 | 4,333 | 9,862 | |
| 1940 | D | 6,852 | 4,693 | 11,563 | |
| 1936 | D | 6,753 | 4,595 | 11,359 | |
| 1932 | D | 6,393 | 5,240 | 11,655 | |
| 1928 | R | 3,814 | 6,099 | 9,927 | |
| 1924 | R | 2,658 | 4,357 | 7,374 | |
| 1920 | R | 2,203 | 4,345 | 6,573 | |
| 1916 | R | 904 | 2,217 | 3,200 | |
| 1912 | R | 560 | 1,023 | 1,698 | |
| 1908 | R | 524 | 1,274 | 1,823 | |
| 1904 | R | 431 | 979 | 1,420 | |
| 1900 | R | 467 | 1,019 | 1,491 | |
| 1896 | R | 340 | 824 | 1,197 | |
| 1892 | R | 346 | 560 | 916 | |
| 1888 | — | — | — | — | |
| 1884 | — | — | — | — | |
| 1880 | — | — | — | — | |
| 1876 | — | — | — | — |
Perry County, anchored by Hazard in the Central Appalachian coalfields, has swung decisively Republican over the past two decades as its once-dominant union-Democratic tradition gave way to cultural and economic realignment — by 2024, the margin reached nearly 60 points.
The Democratic margin in Perry County peaked at thirty-five points in 1964. By 2004 the county had flipped, voting Republican for the first time in many years. The 2024 margin was sixty points, the most Republican-leaning result in the county's modern history.
The economic context is the key. Perry County's median household income of $42,181 sits well below state and national norms, and 27% of residents live below the federal poverty line. The shift here is part of a broader realignment of working-class places across the country. The county's voting pattern over the last decade is most similar to that of Letcher County and Sevier County.