After Elk River flows under Route 101, it meanders across the coastal flatland and turns north behind sand dunes.

In the ocean opposite the mouth are Orford Reef and a portion of the Oregon Islands National Wildlife Refuge.

[3] Fishing, camping, hiking, swimming, and wildlife viewing are among the forms of recreation pursued in the Elk River watershed.

Fishing is permitted within the national forest boundaries only on the 2 miles (3 km) of the river below the confluence with Bald Mountain Creek.

The 17-mile (27 km) segment of the main stem from the confluence of the river's north and south forks to Anvil Creek is classified "recreational.

The area contains one of the nation's largest remaining stands of low-elevation old-growth forest and one of the healthiest salmon, steelhead, and cutthroat trout runs in the continental United States.

Protected species in the region include Port Orford cedar, marbled murrelets and northern spotted owls.