The 2022 St. Louis County Executive special election took place on November 8, 2022. Incumbent Democratic County Executive Sam Page, who was appointed in 2019 following the resignation of Steve Stenger and won a 2020 special election to serve out the remainder of Stenger's term, ran for re-election. He defeated lobbyist Jane Dueker, former chief of staff to Governor Bob Holden, in the general election, and advanced to the general election. Page was originally set to face State Representative Shamed Dogan, but Dogan lost the Republican primary in an upset to activist and conspiracy theorist Katherine Pinner. Pinner subsequently withdrew from the race, and was replaced by businessman Mark Mantovani, a 2018 and 2020 Democratic candidate for County Executive. Page won re-election by a reduced margin from his 2020 victory, winning by a 52–46 margin as opposed to his 58–36 margin two years prior.

Pinner's victory over State Representative Shamed Dogan was viewed as a minor upset, given that Pinner was little-known, had spent little money, and promoted conspiracy theories. Shortly after the primary, Pinner told the local Republican Party that she planned on dropping out of the race for an unspecified reason, reversed her decision and affirmed her commitment to staying in the race, and then dropped out again. Following Pinner's withdrawal, the St. Louis County Republican Party selected businessman Mark Mantovani, a former Democrat who ran for the office in 2018 and 2020, as their nominee.