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Rescue works are set to continue throughout the weekend, and authorities fear more victims may be found as they search through the rubble.
The floods are the worst in a century in some areas, the state governor says.
West Virginia received a quarter of its annual rainfall in a single day, the National Weather Service said.
A storm system dumped up to 10 inches (0.2m) of rain on parts of the state, causing rivers and streams to overflow.
Governor Earl Ray Tomblin said the damage was "widespread and devastating" and that the floods still presented a challenge to rescue efforts.
More than 100 homes were destroyed, some of them torn from their foundations and carried away, and an estimated 66,000 residences were still without power.
Teams removed people from second-storey windows, tops of trees and cars.
Among those rescued were a 97-year-old woman and a family of five including an infant, officials said.
About 500 people were trapped in a shopping centre as crews scrambled to build a new gravel road to reach them.
Meanwhile, officials continued to try to reach others stranded in devastated areas.
A state of emergency was declared in 44 of the state's 55 counties, and up to 500 soldiers have been authorised to assist in the rescue operations.