An 11 mi (18 km) portion of its lower course in West Virginia is designated as the Bluestone National Scenic River.

[6][7] It joins the New River about 4 mi (6.4 km) south of Hinton as part of Bluestone Lake,[1] which is formed by a U.S. Army Corps of Engineers dam on the New.

[7][8] The Bluestone has been compromised by PCB contamination, largely left over from former coal mining activities.

[10] In Virginia, the state Department of Environmental Quality does not recommend any contact recreation (such as swimming or wading) in the Bluestone due to high levels of fecal coliform bacteria.

[11] The Little Bluestone River[12] is a minor tributary of the Bluestone in Summers County, fewer than 10 mi (15 km) in length from its formation by the confluence of two streams, White Oak Branch and Jumping Branch.