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The Košice Self-governing Region cooperates with the following municipalities
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 Borsod-Abaúj-Zemplén County and Nógrád County (Hungary)
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Framework Cooperation Agreement between the Košice and Banská Bystrica Self-governing Regions and the two Hungarian County Governments was signed in April 2004. Its aim is to strengthen and support cross-border cooperation in the field of economic and tourism development, and in transport infrastructure.
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 South Bohemian Region (Czech Republic)
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Memorandum on Cooperation, signed in April 2004, is aimed at regional development, transport and transport infrastructure, healthcare, cultural connections and in support of cooperation among schools and youth organisations.
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 Umbria (Italy)
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| Cooperation Agreement with the aim to support economic sector, investment opportunities, development of agriculture and tourism, school system, research and culture, social sphere, health care service and mutual knowledge of the regions; signed in July 2004. |
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 Transcarpathia (Ukraine)
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| General Agreement with the Transcarpathian State Administration signed in October 2006, is aimed at development of the customs and border infrastructure, partnership networks among municipalities, regional and local authorities and civic associations. It shall support development of investments and international economic activities, tourism and infrastructure and cross-border cooperation between both regions. |
 Rhineland Regional Association (Germany) |
| Partner Agreement on Cooperation, signed in August 2007, is aimed at the area of social welfare and healthcare, assistance to disabled and marginalised citizens, housing, integration into society; at intense exchanges of experience on education, youth, culture; preservation of historical heritage, volunteering, regional culture, media and IT. |
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 Krasnoyarsk (Russia)
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| Agreement on business, economic, scientific, technical and cultural cooperation was signed by the Governor of the Krasnoyarsk Kray and the President of the Košice Self-governing Region in March 2011. Its aims include preservation of cultural and historic heritage and development of cooperation between state and private organisations. |
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 Department Oise (France)
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| Framework Agreement on Cooperation was signed in March 2013 with the aim to strengthen the French-Slovak friendship in support of the unity of the European continent. With respect to the competences of both Authorities, the Agreement will facilitate mutual exchanges. |