The Church of the Nazarene arose as an attempt to unite the scattered groups that identified with the American holiness movement, primarily through the work of the National Holiness Association and its camp meetings in the years from 1867 to the mid-1890s. The church was established as a national body in 1908. The denomination is an offshoot of American Methodism and a member of the World Methodist Council.

The lively and informal tone of the revival service is the customary norm for the Sunday morning worship service (except for celebrations of the Lord's Supper, which are more formal) and the model for the conduct of the evening service. West Virginia Nazarenes, perhaps to a greater degree than Nazarenes elsewhere, have retained the style of revivalism. Most West Virginia Nazarene congregations have continued the custom of holding mid-week prayer and Bible study meetings, and two annual revival meetings (from four days to two weeks), usually with an itinerant evangelist or visiting pastor. They also have continued the tradition of an annual district camp meeting for at least a week each summer. The Nazarene camp and conference ground, established in 1947, at Summersville, has been important in nourishing this tradition.

Sunday school is important to Nazarenes, and until recent years Sunday School enrollment often exceeded church membership. Well into the 1930s, it was not uncommon for the Nazarenes to plant a new congregation by first planting a Sunday school.

The first congregation of the Church of the Nazarene in West Virginia seems to have appeared in 1909 in Martinsburg, where an independent holiness congregation became part of the fledgling denomination. Within a year or two, the Martinsburg congregation appears to have evaporated.

Soon afterwards, Howard Sloan, a dentist and preacher from East Liverpool, Ohio, who served as superintendent of the Pittsburgh District of the Pentecostal Church of the Nazarene, held a revival meeting in Newell, Hancock County. At its close in 1910, he organized the first enduring work of the denomination in West Virginia. Newell First Church began with 13 charter members, most of them skilled pottery workers.

In 1915, a member of the Newell congregation moved to Mannington to work in a pottery factory there and opened his home to a "cottage prayer meeting." The prayer meeting group sponsored a revival meeting, and out of the revival a congregation of 35 was established. The third-oldest surviving congregation in West Virginia is at Grafton. Howard Sloan organized this congregation in 1919, with 14 members.

The Church of the Nazarene came to the Eastern Panhandle in 1939, as a project of the Washington-Philadelphia (now Washington) District. The first congregation, with 21 members, was established in Berkeley Springs after a cottage prayer meeting and tent revival. But it was only in the 1950s that Nazarenes began to think seriously about evangelizing in the east. In short order, they established congregations in Martinsburg, Romney, and Wiley Ford. Both Martinsburg and Romney had experienced abortive attempts earlier, and the congregations there have remained small.

The area of greatest concentration of Nazarenes in West Virginia has been in the Charleston-Huntington corridor. Huntington First, established in 1923, is the oldest congregation in that area. Churches in South Charleston and Charleston, the next oldest, date from 1928; Davis Creek, reputedly the largest rural congregation of any denomination in West Virginia in the 1940s and 1950s, dates from 1930, as does Dunbar.

Women played an active role in the Nazarene ministry from an earlier time than in most other Protestant churches. The first two regular pastors at Davis Creek were Florence Walling (1934—45), who also served Dunbar in 1943, and Vola Vaughn (1945—1947). Alum Creek has had two female pastors, Allie Spencer (1944—47) and Gussie Thaxton (1952—59). A woman remained longest as the pastor in Newell, Lula Kell, from 1917 to 1926. About 20 women have held regular pastoral posts in West Virginia Nazarene churches.

In 2003, the West Virginia North and West Virginia South districts and the Nazarene congregations in the Eastern Panhandle reported a total of 121 congregations, 14,500 members, and a 9,800 weekly average in morning worship. There is at least one Nazarene congregation in all but seven of West Virginia's county seats.