Near St Louis here, and our most famous regional foods are:
Toasted ravioli (which aren't toasted but deep fried). Prepackaged frozen ones are terrible, but fresh pasta ones are okay. Must be served with marinara.
Concretes: Now known all over the country as Blizzards at Dairy Queen, though originally (and at better places around here) made with frozen custard, not soft serve.
Gooey Butter Cakes: a shortbread base, covered with a gooey, VERY sweet layer of sugar, eggs, vanilla, butter (and sometimes cream cheese) which is whipped for quite some time then baked, which creates the gooey layer and a meringue type top. Then it's dusted with powdered sugar because it's just not rich enough.
BBQ Pork steaks: The pork butt (shoulder really) is cut into steaks then slowly bbq'd to make it tender and slathered with bbq sauce throughout the cooking process.
St. Paul Sandwich: a Chinese restaurant staple, it's an egg food young patty fried (can add a protein like chicken or shrimp) in a wok, then served on soft white (i.e. Wonder Bread) with tomato, lettuce, pickle, onion, and mayonnaise (and sometimes bean sprouts, though usually they are in the patty). As a teen I loved these, now I think they are totally vile.
Gerber sandwich: an open face sandwich that is usually on Italian loaf or French baguette slathered with garlic butter, topped with ham (traditionally, but could also be roast beef), and provel or provolone cheese and a sprinkling of paprika and Italian seasoning, then put into a salamander or oven til bubbly hot.