| URBAN LEAGUE OF METROPOLITAN ST LOUIS | Saint Louis | — | $56.4M | 12 |
| CENTRAL METHODIST UNIVERSITY | Fayette | B420 Education | $56.3M | 10 |
| Black River Electric Cooperative | Fredericktown | — | $56M | 14 |
| MISSOURI STATE UNIVERSITY FOUNDATION | Springfield | B110 Education | $55.6M | 5 |
| KIPP ST LOUIS | St Louis | — | $55M | 10 |
| FRIENDS OF THE ZOO INC OF KANSAS CITY MISSOURI C/O LINDA FALK | Kansas City | D115 Animal-Related | $53.6M | 9 |
| THE LIGHTHOUSE FOR THE BLIND | St Louis | — | $53.1M | 8 |
| Affinia Healthcare | St Louis | — | $52.2M | 17 |
| GREAT JOBS KC INC | Kansas City | B82 Education | $51.8M | 7 |
| NEW MAC ELECTRIC COOPERATIVE INC | Neosho | — | $51.7M | 15 |
| MERCY HOSPITAL PERRY | Perryville | E20 Health Care | $51.5M | 12 |
| AMERICAN ANGUS ASSOCIATION | St Joseph | — | $51.5M | 9 |
| SSMHC LIABILITY TRUST I | St Louis | Y200 Mutual & Membership Benefit | $51.4M | 1 |
| MISSOURI COALITION FOR COMMUNITY BEHAVIORAL HEALTHCARE | Jefferson City | — | $51.1M | 7 |
| THREE RIVERS ELECTRIC COOPERATIVE | Linn | — | $50.8M | 15 |
| Ascension Michigan CMG | St Louis | E91Z Health Care | $50.7M | 4 |
| PRESENCE LIFE CONNECTIONS | St Louis | — | $50.5M | 14 |
| MERCY HEALTH SPRINGFIELD COMMUNITIES | Springfield | E210 Health Care | $49.8M | 18 |
| Mo-Kan Sheet Metal Workers Welfare Fund | Kansas City | — | $49.7M | 1 |
| OZARKS FOOD HARVEST INC | Springfield | K300 Food, Agriculture & Nutrition | $49.6M | 1 |
| JOHN BURROUGHS SCHOOL | St Louis | B250 Education | $49.6M | 6 |
| MISSOURI COALITION FOR PRIMARY HEALTH CARE | Jefferson City | — | $49.4M | 8 |
| William Jewell College | Liberty | B420 Education | $47.7M | 12 |
| LOGAN UNIVERSITY INC | Chesterfield | B500 Education | $46.7M | 17 |
| OSAGE VALLEY ELECTRIC COOPERATIVE ASSOCIATION | Butler | — | $46.1M | 16 |
| Mosaic Health System | St Joseph | E12 Health Care | $45.7M | 25 |
| EDWARD JONES FOUNDATION | St Louis | T21 Philanthropy, Voluntarism & Grantmaking Foundations | $45.7M | 0 |
| MISSOURI VALLEY COLLEGE | Marshall | B42Z Education | $45.4M | 10 |
| INTERNATIONAL BROTHERHOOD OF ELECTR WORKERS 683 HEALTH & WELFARE FUND | St Louis | — | $45.3M | 0 |
| SAINT LOUIS SYMPHONY ORCHESTRA | St Louis | A690 Arts, Culture & Humanities | $45.2M | 9 |
| FRIENDSHIP VILLAGE OF WEST COUNTY | Chesterfield | P750 Human Services | $45.2M | 10 |
| HALLMARK EMPLOYEE BENEFIT TRUSTS COMMERCE | Kansas City | — | $45.1M | 1 |
| HEALTH FORWARD FOUNDATION | Kansas City | E99 Health Care | $45.1M | 10 |
| CARROLL COUNTY MEMORIAL HOSPITAL | Carrollton | E220 Health Care | $45.1M | 8 |
| KANSAS CITY ART INSTITUTE | Kansas City | B400 Education | $45.1M | 7 |
| ASCENSION VIA CHRISTI HEALTH PARTNERS INC | St Louis | E190 Health Care | $44.5M | 10 |
| FONTBONNE UNIVERSITY | St Louis | B420 Education | $44.3M | 5 |
| BIG SPRINGS MEDICAL ASSOCIATION INC | Ellington | — | $44.2M | 9 |
| Ascension Medical Group Genesys | St Louis | E11 Health Care | $43.4M | 22 |
| GREATER KC LINC INC | Kansas City | P200 Human Services | $43.2M | 5 |
| WORLDWIDE INVENTORY NETWORK INC | St Louis | T700 Philanthropy, Voluntarism & Grantmaking Foundations | $43.2M | 2 |
| WEBSTER ELECTRIC COOPERATIVE | Marshfield | — | $43M | 18 |
| Owasso Medical Facility Inc | St Louis | E22 Health Care | $42.9M | 9 |
| ST LOUIS ARC INC | St Louis | P820 Human Services | $42.7M | 5 |
| Ranken Technical College | St Louis | B410 Education | $42.7M | 9 |
| IRONWORKERS ST LOUIS DISTRICT COUNCIL WELFARE PLAN | Maryland Heights | — | $42.5M | 0 |
| Forest Park Forever Inc | St Louis | C500 Environment | $42.3M | 9 |
| University of Health Sciences and Pharmacy in St Louis | Saint Louis | B500 Education | $42M | 12 |
| Kansas City CARE Clinic | Kansas City | — | $41.9M | 9 |
| COMMUNITY COUNSELING CENTER | Cape Girardeau | F320 Mental Health & Crisis Intervention | $41.6M | 10 |
