The Proceedings include talks given at the 4th Workshop on Exclusive Reactions at High Momentum Transfer at Jefferson Lab, Newport News, VA USA, the world's leading facility performing research on nuclear, hadronic and quark-gluon structure of matter. Exclusive reactions are becoming one of the major sources of information about the deep structure of the nucleons and other hadrons. The workshop focused on the application of a variety of exclusive reactions at high momentum transfer, utilizing unpolarized and polarized beams and targets, to obtain information about nucleon ground state and excited state structure at short distances. This is a subject which is central to the programs of current accelerators and especially planned future facilities. The topics include: generalized parton distributions, deeply virtual Compton scattering, deeply virtual meson production (DVMP), transverse structure of hadrons (TMD), hadron form factors - elastic and transition, quantum chromodynamics (perturbative, non-perturbative, lattice calculations), and physics to study at an Electron Ion Collider.