From coast to coast, American pizza comes in all shapes, sizes, and stories. (Representational Image: freepik)
MedBound Blog

America's Pizza: Exploring 8 Unique Regional Styles

From New York's foldable slices to Detroit's cheesy pan pies, a tasty tour of the U.S.'s most delicious pizzas

Dr. Pooja Bansal (PT)

Pizza was introduced to the U.S. in the early 20th century by an Italian immigrant in New York City. Originally from Naples, Italy, it didn’t just cross the ocean—it evolved. Americans gave it their own twist, and over time, pizza became not only one of the most beloved comfort foods in the country, but different regions added their adaptations. From coast to coast, its color, texture, recipe, and cooking methods vary. Today, we take a look at nine of the most delicious and fascinating regional pizza styles found across America.

New Haven

New Haven’s ‘apizza’ stands on its own, has charred, chewy, and coal-fired texture.

Locals call it apizza (not “a pizza”)—a twist on the Neapolitan style. It may look like New York-style pizza, but that’s pretty much where the similarity ends.

It’s oval-shaped, coal-fired, and has a chewy, slightly charred crust—thanks to dough that’s fermented overnight. Mozzarella with clams and white sauce is the local favorite, but you’ll find classic meat, cheese, and tomato versions too.

St. Louis

Square-cut and super crisp, St. Louis pizza is all about Provel Cheese.

St. Louis might be known for BBQ, but its pizza has a style of its own. Locals even call it a giant nacho—it’s thin, extra crispy, and made to be shared.

It’s topped with sweet tomato sauce and Provel cheese (a mix of provolone, Swiss, and cheddar). Forget slices—here, it’s cut into squares, and toppings are sliced, not diced, and go edge-to-edge.

New York

A classic New York slice, thin, cheesy, and triangular.

New York pizza is thin, cheesy, and sold in huge triangular slices. It’s a Neapolitan twist, but with more cheese, less sauce, and best enjoyed folded in half like a true New Yorker.

Brought to the U.S. in 1905 by Gennaro Lombardi in Little Italy, this style became a city staple. Cheese is classic, but pepperoni has its fan base, too.

Chicago

Deep-dish, a cheesy, layered pie straight from Chicago.

Chicago does pizza differently. Think deep-dish—baked in a round pan, layered with meat, sauce, and loads of cheese. Fork and knife required.

They also have stuffed pizza (even deeper, more cheese), and tavern-style—thin, crispy, cut into squares, and eaten with your drink at a bar. The city’s got options, depending on how cheesy you want to go.

Detroit

Detroit-style is rectangular, twice-baked, and full of flavor.

Detroit pizza is a thick, rectangular pie with crispy edges, and there’s a fun origin to it. It was first baked in auto parts pans borrowed by Gus Guerra, a bar owner in the 1940s.

This style is baked twice, with the sauce going on last. Why? To keep the crust from getting soggy. It’s light, airy, yet crunchy at the bottom, and usually topped with pepperoni, cheese (often brick cheese), and tomato sauce. It’s simple but made with precision, and the magic happens in the pan.

Philadelphia

Philadelphia tomato pie, thick crust, and rich tomato sauce.

Also known as tomato pie, Philly’s version is thick-crusted, cut into squares, and topped with a generous layer of tomato sauce. But here’s the catch—cheese isn’t a common topping.

This cheese-free pizza has roots in Sicily, where tomatoes were more available than dairy. Immigrants brought the recipe to Philadelphia, adding toppings like onions, oregano, and anchovies. It’s different from Trenton tomato pie or Southern-style tomato pie—so don’t confuse them.

Quad Cities

Quad cities' nutty crust, spicy sauce, and strip-cut slices.

Situated between St. Louis and Chicago, the Quad Cities have a pizza style that’s distinct in every way—from the crust to the sauce and toppings. The dough is made with brewer’s malt, which gives the crust a slightly sweet, nutty flavor. The sauce? It packs a punch with chili flakes and cayenne pepper, adding a spicy kick you won’t find in most other styles.

Popular toppings include Canadian bacon and sausage, with fennel blended into the meat for that extra layer of flavor. One more thing that makes this style stand out: it’s usually cut into strips, not slices, and always finished with a thick, melty layer of cheese.

Ohio Valley

Toppings go on after the oven—Ohio Valley does it differently.

Ohio Valley pizza is pretty different from the others we’ve talked about. Here, the toppings go on after the pizza comes out of the oven. Why? The idea is that the steam inside the box cooks the toppings perfectly without baking them directly.

They pile on plenty of toppings—meat, veggies, lots of cheese, and use tomatoes instead of sauce. Since the toppings are added after baking, they’re cold.

This style gets its name from the Ohio Valley region, which includes Ohio, Indiana, West Virginia, Pennsylvania, and Kentucky.

We’ve covered nine different styles of pizza from across the U.S., each with its unique cheese, toppings, cooking method, shape, or way of cutting. So, which one are you curious to try first?


(Input from various sources)

(Rehash/Pooja Bansal/MSM)

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