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United States
The Holly Steam Combination Company was the first steam heating company to commercially distribute district heating from a central steam heating system. As of 2013, approximately 2,500 district heating and cooling systems existed in the United States, in one form or another, with the majority providing heat.

Major City Systems
On July 18, 2007, one person was killed and numerous others injured when a steam pipe exploded on 41st Street at Lexington. On August 19, 1989, three people were killed in an explosion in Gramercy Park. The Holly Steam Combination Company was the first steam heating company to commercially distribute district heating from a central steam heating system. As of 2013, approximately 2,500 district heating and cooling systems existed in the United States, in one form or another, with the majority providing heat.
 * Lansing Board of Water and Light, a municipal utility system in Lansing, Michigan operates a heated and chilled water system from their existing coal plant. They have announced their new natural gas cogeneration plant will continue to provide this service.
 * Cleveland Thermal operates a district steam (since 1894) from the Canal Road plant near The Flats and district cooling system (since 1993) from Hamilton Avenue plant on the bluffs east of downtown.
 * Fort Chicago Energy Partners L.P. operate district heating/co-generation plants in Ripon, California and San Gabriel, California.
 * District Energy St. Paul operates the largest hot water district heating system in North America and generates the majority of its energy from an adjacent biomass-fueled combined heat and power plant. In March 2011, a 1 MWh thermal solar array was integrated into the system, consisting of 144 20' x 8' solar panels installed on the roof of a customer building, RiverCentre.
 * The California Department of General Services runs a central plant providing district heating to four million square feet in 23 state-owned buildings, including the State Capitol, using high-pressure steam boilers.

Historically, district heating was primarily used in urban areas of the US, but by 1985, it was mainly used in institutions. A handful of smaller municipalities in New England maintained municipal steam into the 21st century, in cities like Holyoke, Massachusetts and Concord, New Hampshire, however the former would end service in 2010 and the latter in 2017, attributing aging infrastructure and capital expenses to their closures. In 2019 Concord, replaced a number of remaining pipes with more efficient ones for a smaller steam system heating only the State House and State Library, mainly due to historic preservation reasons rather than a broader energy plan. District heating is also used on many college campuses, often in combination with district cooling and electricity generation. Colleges using district heating include the University of Texas at Austin; Rice University; Brigham Young University; Georgetown University; Cornell University, which also employs deep water source cooling using the waters of nearby Cayuga Lake; Purdue University; University of Massachusetts Amherst; University of Notre Dame; Michigan State University; Eastern Michigan University; Case Western Reserve University; Iowa State University; University of Delaware; University of Maryland, College Park, University of Wisconsin–Madison, and several campuses of the University of California. MIT installed a cogeneration system in 1995 that provides electricity, heating and cooling to 80% of its campus buildings. The University of New Hampshire has a cogeneration plant run on methane from an adjacent landfill, providing the University with 100% of its heat and power needs without burning oil or natural gas. North Dakota State University (NDSU) in Fargo, North Dakota has used district heating for over a century from their coal-fired heating plant.