Despite a select group of urban centres generating a disproportionate amount of global economic output, significant attention is being devoted to the impact of urban-economic processes on interstitial spaces lying between metropolitan areas. Nevertheless, there remains a noticeable silence in city-region debate concerning how rural spaces are conceptualised, governed and represented. In this paper we draw on recent city-region developments in England and Wales to suggest a paralysis of city-region policymaking has ensued from policy elites constantly swaying between a spatially-selective, city-first, agglomeration perspective on city-regionalism and a spatially-inclusive, region-first, scalar approach which fragments and divides territorial space along historical lines. In the final part we provide a typology of functionally dominant city-region constructs which we suggest offers a way out from the paralysis that currently grips city-region policymaking.