The Elk River is a large stream

Stream

A stream is a body of water with a current, confined within a bed and stream banks. Depending on its locale or certain characteristics, a stream may be referred to as a branch, brook, beck, burn, creek, "crick", gill , kill, lick, rill, river, syke, bayou, rivulet, streamage, wash, run or...

 in the North Carolina

North Carolina

North Carolina is a state located in the southeastern United States. The state borders South Carolina and Georgia to the south, Tennessee to the west and Virginia to the north. North Carolina contains 100 counties. Its capital is Raleigh, and its largest city is Charlotte...

 High Country

Western North Carolina

Western North Carolina is the region of North Carolina which includes the Appalachian Mountains, thus it is often known geographically as the state's Mountain Region. It is sometimes included with upstate South Carolina as the "Western Carolinas", which is also counted as a single media market...

 and East Tennessee

East Tennessee

East Tennessee is a name given to approximately the eastern third of the U.S. state of Tennessee, one of the three Grand Divisions of Tennessee defined in state law. East Tennessee consists of 33 counties, 30 located within the Eastern Time Zone and three counties in the Central Time Zone, namely...

. The headwaters begin from the Northwestern slopes of Peak Mountain

Peak Mountain (North Carolina)

Peak Mountain is a mountain in the North Carolina High Country, near the town of Seven Devils. It is wholly in the Pisgah National Forest. Its elevation reaches ....

 in Avery County, North Carolina

Avery County, North Carolina

- Climate :As a result of its relatively high elevation, Avery County has a Humid continental climate enjoying considerably cooler summers than most of the rest of the Eastern US. Likewise, winters are longer, colder and snowier than most other locations in the region. This can be evidenced by the...

 and end at the Watauga River

Watauga River

The Watauga River is a large stream of western North Carolina and East Tennessee. It is 60 miles long with its headwaters on the slopes of Grandfather Mountain and Peak Mountain in Watauga County, North Carolina.-Hydrography:...

 in Carter County, Tennessee

Carter County, Tennessee

Carter County is a county located in the U.S. state of Tennessee. As of 2010, the population was 57,424. Its county seat is Elizabethton.Carter County is part of the Johnson City Metropolitan Statistical Area, which is a component of the Johnson City–Kingsport–Bristol, TN-VA Combined...

.

Hydrography

With the headwaters beginning from the Northwestern slopes of Peak Mountain

Peak Mountain (North Carolina)

Peak Mountain is a mountain in the North Carolina High Country, near the town of Seven Devils. It is wholly in the Pisgah National Forest. Its elevation reaches ....

, it flows west to Banner Elk

Banner Elk, North Carolina

-Attractions:During summer time there is hiking, whitewater rafting, fishing, and other activities. The largest lake in the area, Watauga Lake, is a favorite spot just 30 minutes away for boating, fishing and wake boarding. In the winter the main event is skiing and snowboarding. There are two...

 then towards Elk Park

Elk Park, North Carolina

Elk Park is a town in Avery County, North Carolina, United States. The town was so named because of the number of Elk killed there. The population was 459 at the 2000 census.-Geography:Elk Park is located at ....

. For most of the river's course, it runs in a deep gorge. Just before the Elk River crosses into Tennessee

Tennessee

Tennessee is a U.S. state located in the Southeastern United States. It has a population of 6,346,105, making it the nation's 17th-largest state by population, and covers , making it the 36th-largest by total land area...

 it flows over "Big Falls" (also called "Elk Falls"), a locally-known attraction which is approximately a 40 foot (12 m) drop. It then flows down a narrow, relatively steep valley to the tiny community of Elk Mills, which is named for a former water-powered mill built on this river at this point by early white settlers. Between the state line and Elk Mills, it flows over Twisting Falls, a drop of approximately 30 feet (nine m). At this point, it is bridged by U.S. Highway 321

U.S. Route 321

U.S. Route 321 is a spur of U.S. Route 21. It runs for 526 miles from South Carolina to Tennessee. The northern terminus of U.S. 321 is between Lenoir City and Oak Ridge, Tennessee, at Interstate 40 exit 364, which is about 4 miles west of Interstate 40's junction with Interstate 75...

. Shortly below this point, it waters become slack as part of an embayment of Watuaga Lake, a sizable reservoir of the Watauga Dam

Watauga Dam

Watauga Dam is a hydroelectric and flood control dam on the Watauga River in Carter County, in the U.S. state of Tennessee. It is owned and operated by the Tennessee Valley Authority, which built the dam in the 1940s as part of efforts to control flooding in the Tennessee River watershed...

 Project of the Tennessee Valley Authority

Tennessee Valley Authority

The Tennessee Valley Authority is a federally owned corporation in the United States created by congressional charter in May 1933 to provide navigation, flood control, electricity generation, fertilizer manufacturing, and economic development in the Tennessee Valley, a region particularly affected...

. This project has flooded the actual site of the original confluence of the Elk and Watauga

Watauga River

The Watauga River is a large stream of western North Carolina and East Tennessee. It is 60 miles long with its headwaters on the slopes of Grandfather Mountain and Peak Mountain in Watauga County, North Carolina.-Hydrography:...

 rivers.

The water eventually flows through the Watauga River

Watauga River

The Watauga River is a large stream of western North Carolina and East Tennessee. It is 60 miles long with its headwaters on the slopes of Grandfather Mountain and Peak Mountain in Watauga County, North Carolina.-Hydrography:...

, the Holston River

Holston River

The Holston River is a major river system of southwestern Virginia and east Tennessee. The three major forks of the Holston rise in southwestern Virginia and have their confluence near Kingsport, Tennessee. The North Fork flows southwest from Sharon Springs in Bland County, Virginia...

, the Tennessee River

Tennessee River

The Tennessee River is the largest tributary of the Ohio River. It is approximately 652 miles long and is located in the southeastern United States in the Tennessee Valley. The river was once popularly known as the Cherokee River, among other names...

, the Ohio River

Ohio River

The Ohio River is the largest tributary, by volume, of the Mississippi River. At the confluence, the Ohio is even bigger than the Mississippi and, thus, is hydrologically the main stream of the whole river system, including the Allegheny River further upstream...

, and the Mississippi River

Mississippi River

The Mississippi River is the largest river system in North America. Flowing entirely in the United States, this river rises in western Minnesota and meanders slowly southwards for to the Mississippi River Delta at the Gulf of Mexico. With its many tributaries, the Mississippi's watershed drains...

 to the Gulf of Mexico

Gulf of Mexico

The Gulf of Mexico is a partially landlocked ocean basin largely surrounded by the North American continent and the island of Cuba. It is bounded on the northeast, north and northwest by the Gulf Coast of the United States, on the southwest and south by Mexico, and on the southeast by Cuba. In...

.

For more information on waterfalls in the Elk River drainage, see Waterfalls of Tennessee by Gregory Plumb, ISBN 1-57072-057-6