The only place you can fly to from Hamilton (outside of Canada) is PHL, on US. At one time, perhaps still, the only airlines using YHM were US, and Royal, before it even had scheduled service. I think there was a total of 4 or 5 flights a day, depending on the day. Very spooky to arrive in an essentially deserted airport. I had to wait for the Avis guy to drive out to the airport (quite a ways from downtown) to set up the contract and give me the keys. He then drove back to town.
There was a big push on then to turn it into a serious alternative to YYZ. You could even drop your business card into a "mailbox" and they sent you a HUGE package of informational material. Don't think it panned out though. But it might yet, with all the talk of discount carriers.