[8] Two notable sinkings related to the Mosquito Fleet occurred in the bay: the Dix in 1906, taking with it dozens of lives, and the Multnomah in 1911.

The craft, named the Flying Cloud, had been the subject of an eight-year restoration project meant to ready it for display at the National Air and Space Museum.

To the east running north and northwest is the heart of Seattle, the Alaskan Way Seawall, the Central Waterfront, and Smith Cove.

[16] The bay is also home to Colman Dock, the main Seattle terminal of the state's ferry system, the largest in the country.

The Seattle–Winslow (Bainbridge Island) route is the most heavily used in the state ferry system in terms of number of vehicles and passengers transported.

[22] Grain is carried to docked cargo ships by passing over Elliott Bay Trail and a narrow shoreline park, which also features a public fishing pier[23] near Smith Cove.

In the cove is Terminal 91, which has served a variety of purposes over the years, including storage for imported automobiles and fish, and most recently became a dock for Alaskan cruise ships.

In "Grey's Anatomy", there is an episode arc in an early season in the series where intern Dr. Meredith Grey, played by Ellen Pompeo, almost dies following a near-drowning when she falls into the bay after being kicked by a patient she is tending to at the scene of a passenger ferry and freight container ship collision; she is rescued just in time by Dr. Derek Shepherd, her friend and the hospital's neurosurgery chief.

In Season 3 of the Seattle-set crime drama The Killing, suspect Ray Seward is incarcerated in the fictional Elliott Bay Penitentiary.

Urban and industrial development along its shores, and on the banks of the Duwamish River that leads into it, have caused concern over the levels of contaminants entering the water.

The downtown waterfront offers a poor habitat for the juvenile salmon that migrate from the Duwamish River, due to the darkness under the piers and the lack of food along the vertical Alaskan Way Seawall.

The level of noise that is currently present in Elliott Bay is legally considered to be harassment of marine mammals (Van, 2016; Welch, 2013; Wilson, 2015).