Nevermind, figured it out! It's in the itch\apps\tanglewood\bin directory. I just renamed the extension from .BIN to .MD (which may not be necessary, but I didn't realize ROMs came in a BIN format).
A member registered Jun 06, 2020
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TANGLEWOOD® (SEGA Mega Drive and Genesis) community · Created a new topic Where do I find the ROM?