The state of Ohio holds a rich tradition of professional vehicle manufacturing that spans over 170 years. Ohio has been the heart of manufacturing throughout the history of the motorized hearse and ambulance . Many of the largest names in professional car manufacturing, Sayers & Scoville, Crane & Breed, A.J. Miller, Meteor, Superior, and Flxible were all Ohio based companies. While leading the nation in funeral, ambulance, and livery vehicle production, Ohio based companies were known for innovation, quality, and design. On June 15, 1909, Crane & Breed Manufacturing Company of Cincinnati introduced the first commercially built motorized hearses. In 1917 the Utility Car Company, also in Cincinnati, produced the first motorized vehicle marketed as a processional flower car. In 1938 the first all-steel welded construction coaches were introduced by Superior Coach Corporation of Lima. That same year, Sayers & Scoville Company of Cincinnati unveiled their new model funeral coach, the Victoria. With its thickly padded top and massive, prominent landau iron, the Victoria set the standard of design on which nearly every funeral car produced in the United States has been based. The landau iron is the single most publicly recognizable feature of a hearse in the United States today.

Elegance and quality have long been the hallmark of Ohio's professional car companies. The Riddle Coach & Hearse Company of Ravenna built the hearses which bore the bodies of United States Presidents William McKinley in 1901 and Warren G. Harding in 1923. A restored Riddle hearse was used for the funeral of Roy Rogers in 1998. The Hess & Eisenhardt Company of Cincinnati is world renowned for the construction of armored limousines. Hess & Eisenhardt has supplied limousines to statesmen, royalty, and United States Presidents.

In 1941 the A.J Miller company introduced Tu/Level attendant seating in ambulances and combination vehicles, a feature used by every other coach builder until the late 1970's. Just as Ohio stood at the forefront of professional vehicle manufacturing, it also stood sadly at the end of an era. With federal regulations ringing the death knoll for passenger car based ambulances and combination vehicles, Superior Coach Corporation built the last Cadillac ambulance in the United States in 1979.

Although the cars have changed and many companies have been sold over the decades, funeral and emergency vehicle production continues in Ohio in the twenty first century.