About four miles south of its source, it passes through McConnellsburg, the only town of note along its course.
Just below, Esther Run cuts a deep gap between Dickeys Mountain and Lowery Knob to enter it from the east.
It passes through an outlying parcel of Buchanan State Forest, then hugs the west side of the valley while Route 928 climbs away on the east side.
It finally joins Licking Creek north of the town of Dickeys Mountain.
In 2017, the Pennsylvania Fish and Boat Commission announced that a part of Big Cove Creek near Big Cove Tannery in Fulton County, had been selected as one of 14 Keystone Select Stocked Trout Waters to be stocked with 14- to 20-inch trout.