Hockey Northwestern Ontario has traditionally not had an Under 18/Major Midget league of its' own. The Kenora AAA Thistles have been a member of the Manitoba AAA U18 Hockey League since the 2009-10 season. The Thunder Bay Kings Midget AAA team has played on and off in the Lakehead Junior Hockey League. When there have been two teams in the region they traditionally play a best-of-three series for the branch championship and spot in the Telus Cup West Regional. When three teams have been involved a round robin with the top two teams playing a championship has been done.
The present format used for qualifying for the Telus Cup began with the 1984 tournament. The regional champion advances to the Telus Cup West Regional playing in a tournament against the champions of the Manitoba AAA U18 Hockey League, Saskatchewan Male U18 AAA Hockey League and a host team. The winner of this tournament then advances to the Telus Cup.
Prior to 1984 each branch under Hockey Canada sent its' own representative to the then Air Canada Cup.
The Midget/U18 AAA championship is the Don Smith Cup.
Tournaments[]
Air Canada Cup Era[]
| Year | Champion | Air Canada Cup |
| 1974 | Westfort Hurricanes | 10th place |
| 1975 | Thunder Bay Miners | 7th place |
| 1976 | Thunder Bay Lions | 6th place |
| 1977 | Manitouwadge Flyers | 11th place |
| 1978 | Fort William | 9th place |
| 1979 | Andrews Maroons | 12th place |
| 1980 | Fort Frances Boise Cascade | 12th |
| 1981 | Current River Comets | 4th |
| 1982 | Andrews Maroons | 6th |
| 1983 | Andrews Maroons | Bronze Medal |