[2] The Elk River rises in Grundy County, Tennessee, in Burroughs Cove near the community of Elkhead.

This reservoir was built under the auspices of the United States Army Corps of Engineers, primarily to provide a large source of cooling water for the U.S. Air Force's Arnold Engineering Development Center, which has large wind tunnels and other military and scientific research equipment.

It is bridged near the small community of Kelso, site of a cave used as a saltpeter mine by Confederates during the Civil War, by U.S. Route 64.

Several miles west of Fayetteville, it is crossed by State Route 274, a highway built on an old railroad bed.

This Elk River flows from the back side of Beech Mountain, North Carolina through Carter County, Tennessee and empties into Watauga Lake.

Outside of Winchester, TN Tims Ford Lake was created by damming the Elk River which allows for boating and water based activities.