The Bluestone River and the rugged gorge it has carved make up a richly diverse and scenic area of the Appalachian Plateau.

The river cuts into Mississippian and Pennsylvanian sedimentary rocks of the Mauch Chunk and Pottsville groups in southern West Virginia according to geologic mapping carried out by researchers at nearby Concord University.

The riverbed habitat is alive with a carpet of macro-invertebrate aquatic species, and supports healthy populations of many warm water game and non-game fishes.

The Bluestone River is classified as a High Quality Warm Water Stream by the state of West Virginia.

Many native prehistoric sites, from nomadic Paleo-Indian hunting camps dating back to the times of Ice-Age mammoth and mastodon, through hundreds of generations of village and burial sites of the Archaic and Woodland cultures, to the Delaware, Cherokee and Shawnee tribes of the 17th and 18th centuries, have been documented throughout the Bluestone River watershed.

Because Bluestone National Scenic River lies in a deep gorge with no immediate road access, getting to the area can be challenging.

At the upstream end, visitors can ride the seasonal aerial tram at Pipestem Resort State Park to reach the bottom of the gorge.