'Super Thursday' will see a number of elections take place that were postponed from last year due to Covid, with the results seen as a crucial guide to the progress of the two main parties.
One third of seats are up for grabs on all four Black Country councils and in Cannock Chase, while votes will also be cast for all seats on Staffordshire County Council.
All you need to know about the 2021 elections:
Stay posted in the coming days for all the results as they happen
Elections are also taking place for police and crime commissioners in Staffordshire and the West Midlands, and for West Midlands Mayor.
As the clock ticked down to polling time both Prime Minister Boris Johnson and Labour leader Sir Keir Starmer visited the region as part of a final push to win votes.
Mr Johnson joined Mayor Andy Street on the campaign trail in Stourbridge, where the pair handed out leaflets at a Kwik-Fit garage before cycling down the side of a canal.
They also visited Stourbridge FC’s War Memorial Ground with the town’s MP Suzanne Webb, Dudley Council leader Patrick Harley and Tory PCC candidate Jay Singh-Sohal
The PM said the battle between former John Lewis boss Mr Street and his Labour opponent was likely to be "very close", as he played down opinion polls which have put the Tory well ahead.
He said a vote for Mr Street, who is seeking a second term as Mayor, would "boost skills and drive long term growth in jobs" in the region.
Mr Johnson's second visit to the Black Country in two weeks came as he bids to move on from allegations around lobbying and cronyism in his party.
Sir Keir, meanwhile, was in Birmingham where he talked up the chances of Labour's mayoral candidate Liam Byrne.
The Labour leader said Birmingham MP Mr Byrne had a "vision of a new future for the heart of Britain".
He said these elections were about a "rebuild" for Labour ahead of the next general election, but warned it would take "longer than a year" for the party to get back on its feet.
The elections mark Sir Keir's first big test at the polls since becoming Labour leader.
It has been suggested he faces an uphill battle to win over voters in places such as the Black Country and Staffordshire, which have turned strongly towards the Tories in recent years.
The elections are the biggest outside of a general election, with 143 local councils going to the polls. There is also a parliamentary by-election in Hartlepool, the latest Labour stronghold which the Tories have designs on.
In the Black Country Dudley and Walsall are on a knife edge and could go either way, while Cannock Chase, which is currently under a Labour-led minority administration, is also expected to be tight.
The Conservatives are attempting to gain representation on Labour-dominated Sandwell Council, and are also bidding to loosen Labour's grip on Wolverhampton Council.
Polls opened at 7am, and voters have been asked to wear a mask, stick to social distancing rules and take their own pen or pencil.
Results are due from Friday morning onwards.