| 1 | Carilion Medical Center | Health Care | $2.2B | $2.2B |
| 2 | Delta Dental Plan of Virginia | Health Care | $877.7M | $207.7M |
| 3 | Carilion Services INC | Health Care | $457.6M | $1.2B |
| 4 | Carilion New River Valley Medical Center | Health Care | $413.5M | $505.2M |
| 5 | Hollins University Corporation | Education | $302.6M | $388.0M |
| 6 | Goodwill Industries of the Valley Works | Human Services | $104.2M | $47.5M |
| 7 | Carilion Giles Community Hospital | Health Care | $101.5M | $50.4M |
| 8 | Carilion Franklin Memorial Hospital | Health Care | $98.9M | $56.4M |
| 9 | Carilion Rockbridge Community Hospital | Health Care | $89.7M | $86.8M |
| 10 | Richfield Living | Health Care | $85.9M | $434K |
| 11 | Lutheran Family Services of Virginia INC | Human Services | $56.4M | $25.3M |
| 12 | Carilion Clinic | Health Care | $42.5M | $268.8M |
| 13 | Virginia Lutheran Homes INC | Unclassified | $32.0M | $80.7M |
| 14 | Friendship Health and Rehab Center INC | Health Care | $30.8M | $36.0M |
| 15 | Total Action Against Poverty in Roanoke Valley | Human Services | $29.1M | $18.8M |
| 16 | Goodwill Industries of the Valleys INC | Employment | $28.4M | $76.0M |
| 17 | Friendship Foundation | Philanthropy, Voluntarism & Grantmaking | $27.8M | $103.4M |
| 18 | Depaul Community Resources | Unclassified | $26.4M | $12.6M |
| 19 | Carilion Tazewell Community Hospital | Health Care | $23.8M | $8.8M |
| 20 | Carilion Clinic Foundation | Health Care | $20.6M | $72.4M |
| 21 | Our Lady of Hope Health Center INC | Unclassified | $20.5M | $22.3M |
| 22 | Good Samaritan Hospice INC | Health Care | $19.2M | $19.5M |
| 23 | Friendship Health and Rehab Center South INC | Health Care | $17.3M | $23.6M |
| 24 | North Cross School | Education | $17.1M | $26.6M |
| 25 | Our Lady of the Valley INC | Unclassified | $16.6M | $22.1M |
| 26 | Virginia Utility Protection Service INC | Community Improvement & Capacity Building | $15.5M | $18.2M |
| 27 | Young Mens Christian Association of Virginias Blue Ridge INC | Unclassified | $15.4M | $30.3M |
| 28 | Our Lady of Peace INC | Housing & Shelter | $13.9M | $17.7M |
| 29 | Community Foundation Serving Western Virginia | Philanthropy, Voluntarism & Grantmaking | $13.3M | $138.6M |
| 30 | Kuumba Community Health & Wellness Center INC | Health Care | $13.3M | $12.7M |
| 31 | Our Lady of Perpetual Help Health Center INC | Human Services | $12.8M | $15.2M |
| 32 | Virginia Transformer Corp Health Care Benefits Trust | Unclassified | $12.8M | $0 |
| 33 | Southeast Rural Community Assistance Project INC | Public & Societal Benefit | $10.6M | $10.5M |
| 34 | Laborers International Union of North America | Unclassified | $10.6M | $9.8M |
| 35 | McLeod Family Foundation INC | Philanthropy, Voluntarism & Grantmaking | $8.7M | $35.5M |
| 36 | Marian Manor INC | Human Services | $8.5M | $11.0M |
| 37 | Unified Human Services Transportation System INC | Human Services | $7.8M | $6.4M |
| 38 | Friendship Apartment Village Corporation | Housing & Shelter | $7.7M | $31.2M |
| 39 | Sam and Marion Golden Helping Hand Foundation INC | Unclassified | $7.6M | $22.7M |
| 40 | Bradley Free Clinic of Roanoke Valley | Unclassified | $7.4M | $11.5M |
| 41 | Habitat for Humanity in the Roanoke Valley INC | Unclassified | $7.4M | $11.1M |
| 42 | Council of Community Services | Human Services | $6.9M | $3.3M |
| 43 | The Taubman Museum of Art | Arts, Culture & Humanities | $6.8M | $73.4M |
| 44 | Chesterbrook Residences INC | Human Services | $6.6M | $17.6M |
| 45 | Boy Scouts of America | Unclassified | $6.1M | $2.9M |
| 46 | Life Sciences Trainers & Educators | Health Care | $6.0M | $5.8M |
| 47 | Rescue Mission of Roanoke INC | Human Services | $6.0M | $11.2M |
| 48 | United Way of Virginias Blue Ridge | Philanthropy, Voluntarism & Grantmaking | $5.7M | $8.0M |
| 49 | Blue Ridge Public Television | Arts, Culture & Humanities | $5.7M | $5.8M |
| 50 | Girl Scouts of Virginia Skyline Council INC | Unclassified | $5.6M | $5.9M |
| 51 | Renewanation | Education | $5.3M | $6.3M |
| 52 | Roanoke Country Club INC | Unclassified | $5.1M | $4.3M |
| 53 | The Horace G Fralin Charitable Trust | Unclassified | $4.9M | $43.7M |
| 54 | Assisi Animal Clinics of Virginia INC | Animal-Related | $4.6M | $5.9M |
| 55 | Faith Christian School | Education | $4.5M | $6.4M |
| 56 | Disabled American Veterans | Unclassified | $4.4M | $23.1M |
| 57 | Ironworkers Health and Welfare Fund of the Richmond Virginia Area | Unclassified | $4.4M | $14.7M |
| 58 | Taubman Foundation for the Arts | Philanthropy, Voluntarism & Grantmaking | $4.3M | $12.2M |
| 59 | National Pku Alliance INC | Medical Research | $4.3M | $5.3M |
| 60 | Eastwood Assisted Living INC | Health Care | $4.2M | $2.6M |
| 61 | Louise R Lester Foundation INC | Philanthropy, Voluntarism & Grantmaking | $4.2M | $13.3M |
| 62 | Roanoke Valley Convention and Vis- Itors Bureau | Unclassified | $4.1M | $3.4M |
| 63 | Corvesta INC | Health Care | $4.1M | $108.8M |
| 64 | Local Office on Aging INC | Human Services | $3.9M | $5.0M |
| 65 | Western Virginia Foundation for the Arts and Sciences | Arts, Culture & Humanities | $3.8M | $32.8M |
| 66 | Kirk Foundation | Philanthropy, Voluntarism & Grantmaking | $3.7M | $3.6M |
| 67 | Brain Injury Services of Swva | Diseases, Disorders & Medical Disciplines | $3.3M | $2.5M |
| 68 | Certified Medical Representatives Institute INC | Unclassified | $3.2M | $3.9M |
| 69 | Blue Ridge Behavioral Healthcare INC | Unclassified | $3.2M | $14.7M |
| 70 | Roanoke Valley Youth Soccer Club INC | Recreation & Sports | $2.9M | $1.4M |
| 71 | Rbm Opco of Fincastle LLC | Unclassified | $2.8M | $371K |
| 72 | Jefferson Center Foundation Ltd | Arts, Culture & Humanities | $2.8M | $22.7M |
| 73 | Ronald McDonald House Charities of Southwest Virginia INC | Philanthropy, Voluntarism & Grantmaking | $2.7M | $3.6M |
| 74 | Kissito Healthcare INC | Unclassified | $2.6M | $371K |
| 75 | Roanoke Area Ministries | Unclassified | $2.6M | $1.6M |
| 76 | Greater Roanoke Workforce Development Board | Human Services | $2.5M | $808K |
| 77 | Saint Basil Academy Trust | Unclassified | $2.5M | $8.5M |
| 78 | Virginia Western Community College Educational Founation INC | Education | $2.4M | $34.6M |
| 79 | Boys & Girls Clubs of Southwest Virginia INC | Youth Development | $2.4M | $2.5M |
| 80 | Virginia Museum of Transportation INC | Arts, Culture & Humanities | $2.3M | $7.1M |
| 81 | Roanoke Symphony Orchestra | Arts, Culture & Humanities | $2.3M | $1.8M |
| 82 | Local Environmental Agriculture Project Incorporated | Food, Agriculture & Nutrition | $2.3M | $2.6M |
| 83 | Life Ring Foundation | Philanthropy, Voluntarism & Grantmaking | $2.3M | $1.9M |
| 84 | Family Service of Roanoke Valley | Human Services | $2.2M | $2.2M |
| 85 | Farrell Foundation | Unclassified | $2.2M | $6.3M |
| 86 | Legal Aid Society of Roanoke Valley INC | Unclassified | $2.1M | $1.9M |
| 87 | Community School | Education | $2.1M | $3.8M |
| 88 | Western Virginia Emergency Medical Services Council INC | Health Care | $2.1M | $2.4M |
| 89 | The Shenandoah Club | Unclassified | $2.0M | $738K |
| 90 | Delta Dental of Virginia Foundation INC | Health Care | $2.0M | $521K |
| 91 | Downtown Roanoke Incorporated | Unclassified | $2.0M | $1.2M |
| 92 | Scott Hill Incorporated | Housing & Shelter | $2.0M | $2.3M |
| 93 | Presbyterian Community Center INC | Human Services | $2.0M | $6.8M |
| 94 | Mary Sue Collins Foundation | Philanthropy, Voluntarism & Grantmaking | $2.0M | $7.1M |
| 95 | Roanoke Valley SPCA | Animal-Related | $1.7M | $5.6M |
| 96 | Free Foundation for Rehabilitation Equipment & Endowment | Human Services | $1.7M | $724K |
| 97 | Va United Futbol Club | Recreation & Sports | $1.7M | $263K |
| 98 | Child Health Investment Partnership | Unclassified | $1.6M | $3.9M |
| 99 | Benevolent & Protective Order of Elks of the USA | Unclassified | $1.6M | $1.1M |
| 100 | Blue Ridge Zoological Society of Virginia INC | Animal-Related | $1.6M | $2.0M |