Through-hole mounted semiconductor assemblies are described. A printed circuit board (“PCB”) has first and second PCB sides and has a through hole therein. The through hole defines a hole area. A semiconductor package may be disposed in the hole area such that the semiconductor package is at least partially exposed on one or more of the first and the second PCB sides. Package contacts on the semiconductor package may be electrically coupled to PCB contacts disposed on one or more of the PCB sides. In some embodiments, one or more support structures may be coupled to the PCB and may touch the semiconductor package. In some embodiments, cooling devices may be placed in thermal communication with the semiconductor package on both sides of the PCB.