| TRI-COUNTY MENTAL HEALTH SERVICES INC | Kansas City | F99Z Mental Health & Crisis Intervention | $26.2M | 9 |
| HOWELL OREGON ELECTRIC COOPERATIVE INC | West Plains | — | $26.1M | 20 |
| ST VINCENT MADISON COUNTY HEALTH SYSTEM INC | St Louis | E22Z Health Care | $26M | 18 |
| ASCENSION STANDISH HOSPITAL | St Louis | E22Z Health Care | $25.9M | 16 |
| JEWISH COMMUNITY CENTER | St Louis | P280 Human Services | $25.8M | 6 |
| St John Sapulpa Inc | St Louis | E22Z Health Care | $25.8M | 7 |
| St Vincent Jennings Hospital Inc | St Louis | E21Z Health Care | $25.7M | 16 |
| JOHNNY MORRIS' OZARKS HERITAGE PRESERVE | Springfield | D30 Animal-Related | $25.7M | 4 |
| ASCENSION RIVER DISTRICT HOSPITAL | St Louis | E20 Health Care | $25.7M | 13 |
| KC PEOPLE'S FUND | Kansas City | T20 Philanthropy, Voluntarism & Grantmaking Foundations | $25.6M | 3 |
| CENTRAL MISSOURI COMMUNITY ACTION | Columbia | — | $25.6M | 2 |
| JAMES S MCDONNELL FOUNDATION | St Louis | T22 Philanthropy, Voluntarism & Grantmaking Foundations | $25.6M | 1 |
| BELLERIVE COUNTRY CLUB | Saint Louis | — | $25.5M | 6 |
| NORTHWEST HEALTH SERVICES INC | Mound City | — | $25.5M | 8 |
| SOUTHEAST MISSOURI HEALTH NETWORK | Benton | — | $25.5M | 11 |
| COMMUNITY HOSPITAL ASSOCIATION INC | Fairfax | E22 Health Care | $25.4M | 8 |
| STARLIGHT THEATRE ASSOCIATION OF KANSAS | Kansas City | A610 Arts, Culture & Humanities | $25.4M | 11 |
| ST ANDREWS RESOURCES FOR SENIORS | St Louis | P750 Human Services | $25.3M | 6 |
| ST LOUIS DEVELOPMENT CORPORATION | St Louis | — | $25.2M | 7 |
| Assemblies of God Credit Union | Springfield | — | $25.1M | 10 |
| MIDWAY USA FOUNDATION INC | Columbia | T30 Philanthropy, Voluntarism & Grantmaking Foundations | $24.9M | 4 |
| Gascosage Electric Cooperative | Dixon | — | $24.8M | 16 |
| RICHLAND MEDICAL CENTER | Richland | — | $24.7M | 8 |
| AMERICAN ASSOCIATION OF ORTHODONTISTS | St Louis | — | $24.6M | 23 |
| NAZARETH LIVING CENTER | St Louis | E910 Health Care | $24.6M | 5 |
| SOUTHEAST MISSOURI FOOD BANK INC | Sikeston | K31Z Food, Agriculture & Nutrition | $24.6M | 1 |
| ST VINCENT WILLIAMSPORT HOSPITAL INC | St Louis | — | $24.5M | 16 |
| MURIEL MCBRIEN KAUFFMAN FAMILY | Kansas City | — | $24.5M | 10 |
| Mercy Hospital Cassville | Cassville | E210 Health Care | $24.4M | 12 |
| INTERNATIONAL INSTITUTE OF METROPOLITAN | St Louis | P84Z Human Services | $24.4M | 4 |
| Sac Osage Electric Cooperative Inc | El Dorado Springs | — | $24.1M | 17 |
| EWING MARION KAUFFMAN SCHOOL INC | Kansas City | B29 Education | $24.1M | 5 |
| City Union Mission | Kansas City | L410 Housing & Shelter | $23.9M | 3 |
| PAULA AND RODGER RINEY FOUNDATION | St Louis | T22 Philanthropy, Voluntarism & Grantmaking Foundations | $23.9M | 1 |
| Genesys Ambulatory Health Services | St Louis | E320 Health Care | $23.8M | 12 |
| Rockhill Orthopaedic Specialists Inc | Kansas City | E21 Health Care | $23.7M | 4 |
| SENIORAGE AREA AGENCY ON AGING | Springfield | P81Z Human Services | $23.6M | 8 |
| SOCIETY OF ST VINCENT DE PAUL | St Louis | P200 Human Services | $23.5M | 1 |
| Woodhaven Learning Center | Columbia | — | $23.4M | 8 |
| THE MARVIN M SCHWAN CHARITABLE FOUNDATION | Earth City | X120 Religion-Related | $23.4M | 5 |
| Northwest Medical Center Association Inc | St Joseph | — | $23.3M | 15 |
| FOSTERADOPT CONNECT INC | Independence | P32 Human Services | $23.2M | 6 |
| WORLDWIDE INVENTORY NETWORK INC | St Louis | T700 Philanthropy, Voluntarism & Grantmaking Foundations | $23.1M | 2 |
| Alexian Brothers Hospital Network | St Louis | E210 Health Care | $23.1M | 8 |
| BETHESDA SENIOR LIVING INC | St Louis | L220 Housing & Shelter | $23.1M | 12 |
| SAINT FRANCIS HEALTHCARE REAL ESTATE | Cape Girardeau | E11 Health Care | $23M | 2 |
| HERMANN FAMILY FOUNDATION | St Louis | — | $22.8M | 0 |
| THE BARSTOW SCHOOL | Kansas City | — | $22.8M | 5 |
| KUMMER MISSOURI S&T FOUNDATION | Rolla | B11 Education | $22.7M | 1 |
| COTTEY COLLEGE | Nevada | B410 Education | $22.6M | 3 |
