Councils are bracing themselves for tough spending cuts as the Chancellor puts the finishing touches to his emergency budget.
The coalition government has already outlined £6.2bn of spending cuts for this year and will spell out additional public spending cuts on 22 June.
The results of a comprehensive spending review are also expected in the autumn.
The fear is many projects will fall victim as George Osborne attempts to cut the UK deficit.
Schemes facing the axe across the Midlands range from community groups to new road and rail links.
Shropshire Council estimates it will have to save £16m to £18m every year for the next three years.
John Dodson, chairman of the county's senior citizens forum, said he was concerned about frontline services for elderly people
Mr Dodson said issues potentially at risk included preventative care, mental health care, and carer strategy.
"Eighty per cent of elderly people get depression, a major increase in the population, so to do anything which would cause a problem in that area would be regressive," he said.
"Carer strategy is one of the biggest issues of all. A large proportion of them are not officially known as carers, but in reality are carers.
"What we are concerned about is if any provisions for them are cut."
Neighbouring Worcestershire County Council has to save around £15m a year over the next three years.
The council is considering making savings in a range of areas - perhaps the most controversial being the introducetion of parking charges on every street in every town in the county.
Other ideas include turning street lights off in the early hours of the morning, privatising more of their social care provision and making many services online-only.
In Birmingham the Bangladeshi Youth Forum fears any cuts to its funding from the city council could see it fold.
"Ultimately the organisation could collapse," a spokesman said.
"We will be making redundancies and that will add to unemployment.
"If there are funding cuts, which are possible, it's not going to affect just us but also the community."
The Coalition government is also reviewing all capital expenditure projects approved by the last Government since January - the results are expected in September.
A flagship public transport project in the Midlands is the expansion of the Metro tram service in Birmingham.
A £127.1m plan to extend the service from its terminus at Birmingham's Snow Hill station to New Street station received the go-ahead in March.
A spokesman for Centro, the organisation responsible for public transport in the West Midlands, said it would be pressing the case with the Department of Transport over the summer.
He said: "The Metro extension has a very strong business case offering good value for money.
"It will provide a fifty million a year boost to the region's economy, create 1,300 sustainable new jobs and provide improved connectivity, linking people to jobs, education, training leisure and health care.
"We remain confident it meets the Coalition's agenda for jobs and regeneration."