It is one of the lowest-income counties in the United States, partly due to the presence of Little Sandy Correctional Complex.

People of British ancestry form an overwhelming plurality in Elliott County.

According to interviews from residents of the county, this overwhelming Democratic support was primarily due to love for tradition as well as an appreciation for big government following FDR's New Deal.

Reagan, in particular, only performed 3% better in the county in 1984 than 1936 GOP nominee Alf Landon, despite the fact that Reagan won everywhere but Minnesota and Washington, D.C., and a national popular vote swing of 41%, while Landon lost every state but Maine and Vermont.

Obama would again win the county in 2012, his only such victory in the staunchly conservative region of rural Eastern Kentucky.

However, he eked out only a narrow 49.4% plurality over Mitt Romney's 46.9%, thus ending an over century-long streak of Democratic landslides in Elliott County.

The county is part of the Bible Belt, and according to interviews residents are socially conservative on issues such as LGBT rights.

[24] Elliott County's hard swing towards the Republican Party continued in 2016, when it voted for Republican Donald Trump over Democrat Hillary Clinton by a 70.1–25.9% margin,[25] decisively ending the Democratic Party's 140-year victory streak.

[20] Despite Trump's victory, Democratic candidates for down-ballot offices managed to carry the county.

By 2024, Trump managed to make Elliott an even deeper shade of red, getting 80% of the vote, a figure that once was more commonly associated with fiercely Unionist Kentucky counties like Jackson and Clay.

[27] Until the 2020s, the county remained reliably Democratic in state-level races, voting for the party's entire slate in the 2015 and 2019 statewide elections.

Democratic governor Andy Beshear's vote share also decreased in Elliott County, from 59.27% in 2019 to 53.48% in 2023, despite winning by a higher margin statewide in 2023.