While most published studies on the economy of culture present a clear bias in favor of large cities, a significant international bibliography has emerged in recent years that privileges the perspective of medium and small cities. Unfortunately, the case of Spain has been largely overlooked by these analyses; this text is intended to remedy that oversight. To that end, a bibliographic compilation has been undertaken of studies on the cultural economy and cultural development in small and medium Spanish cities, providing a review of the specific literature as contrasted with the international literature. The main conclusions indicate that the Spanish case is similar to that of other western countries. Thus, clear confirmation is found that the effects of agglomeration economies and the so-called metropolitan bias also prevail in Spain, together with dispersion patterns that, to a certain extent, favor particular small and medium cities. Furthermore, even though the literature on the use of culture for urban renewal is abundant, the same cannot be said for the economics of culture, where considerable research gaps persist, both in the geographical coverage of case studies and in the social or labor impacts of this economic model.