This study aims to diagnose the current issues of regeneration policies in local small and medium-sized cities implemented within the evolving landscape of urban regeneration policies and to derive future policy directions and tasks. To this end, we examined the status of urban regeneration and related policies over the past decade since the enactment of the “Urban Regeneration Act.” We analyzed the implementation status of regeneration projects in local small and medium-sized cities to derive implications. Based on this analysis, we examined the project implementation characteristics of empirical case study areas that have pursued long-term urban regeneration projects to propose future directions and policy tasks for regeneration policies in local small and medium-sized cities.