The earliest center of artistic activities in Ohio was Cincinnati, where a group of young painters did landscapes and portraits as early as 1840. The state's first art gallery was established there in 1854; the Cincinnati Art Academy was founded in 1869, and the Art Museum in 1886. Famous American artists who worked in Cincinnati during part of their careers include Thomas Cole, a founder of the "Hudson River School" of landscape painting, and Columbus-born George Bellows, whose realistic Stag at Sharkey's is displayed at the Cleveland Museum of Art (founded in 1913). Other notable centers for the visual arts include the Akron Art Institute, Columbus Museum of Art, Dayton Art Institute, Toledo Museum of Art, and museums or galleries in Marion, Oberlin, Springfield, Youngstown, and Zanesville.

Cincinnati also was an early center for the theater; the Eagle Theater opened there in 1839, and shortly afterward, the first showboat on the Ohio River began making regular stops at the city. The first US minstrel show appeared in Ohio in 1842. Ohio has three professional theatrical companies: the Cincinnati Playhouse, the Cleveland Play House (the nation's oldest permanent repertory theater), and the Great Lakes Theatre Festival. The Ohio Community Theater Association included groups in Akron, Canton, Columbus, Mansfield, Toledo, and Youngstown.

The Cincinnati Symphony was founded in 1895 and reorganized in 1909 with Leopold Stokowski as conductor. The Cincinnati Pops Orchestra acquired a new summer home in 1984 at the newly opened Riverbend Music Center. The Cincinnati Opera Association, founded in 1920, is the 2nd-oldest opera company in the United States. Cincinnati is also the host of the annual Cincinnati May Festival, a classical music event that is considered to be the oldest continuous choral festival in the Western Hemisphere.

The Cleveland Orchestra, founded in 1918, has risen to world-class stature since 1946, when George Szell began his 24-year tenure as conductor and music director. Blossom Music Center, the Cleveland Orchestra's summer home located between Cleveland and Akron, has been a center for both classical and popular music in Northeast Ohio since opening in 1968. In 2002/2003 Blossom underwent major improvements to its structures and landscaping. A $36.7 million renovation and expansion of the orchestra's main home, Severance Hall, had been completed three years earlier.

Smaller professional musical groups in Cleveland include Apollo's Fire (the Cleveland Baroque Orchestra), the Cleveland Chamber Orchestra, and the Cleveland Pops Orchestra. The Cleveland Opera finds its home at the State Theatre and the Lyric Opera Cleveland is a resident of Playhouse Square, the nation's largest performing arts center outside of New York.

There are civic symphony orchestras in Columbus, Dayton, Toledo, and Youngstown. Ballet companies are based in Cincinnati, Dayton, and Toledo. E. J. Thomas Hall in Akron is the home of the Ohio Ballet and the Akron Symphony. Operas are performed by resident companies in Cleveland, Columbus, Cincinnati, Toledo, and Dayton. There are numerous local arts festivals and craft shows.

The nation's first college music department was established at Oberlin College in 1865; the Cincinnati Conservatory of Music was established in 1867, the Baldwin-Wallace College Conservatory in 1899, and the Cleveland Institute of Music in 1920. The Baldwin-Wallace Bach Festival, begun in 1932, is the oldest collegiate Bach festival in the country. Bach's four major choral works are performed at the festival in four-year cycles (one per year). Baldwin-Wallace is also home to the Riemenschneider Bach Institute.

The Cleveland International Piano Competition, held biennially at the Cleveland Institute of Music since 1975, has become one of the foremost events of its type, drawing contestants from 19 countries throughout the world in 2003.

In 2003, the Ohio Arts Council and other Ohio arts organizations received grants totaling $1,617,800 from the National Endowment for the Arts. State and private sources contributed funds to arts programming as well. The Ohio Humanities Council presents a number of historical and literary programs, including Booked for the Day: Literary Retreats for Working Professionals. In 2000, the National Endowment for the Humanities contributed $2,821,510 to 50 state programs. The state has over 2,000 arts associations and about 100 local arts groups.