The Interstate Box Lacrosse Association expanded to Ohio in 2018 and three years later the region has expanded from two to four teams. The IBLA is the largest adult box lacrosse league in the USA with over 40 teams across 17 regions. The winner of each region attends the IBLA Nationals each year. The location of the IBLA Nationals rotates each year. The IBLA is a partner and developmental league of the National Lacrosse League.