It contains the counties of Bell, Boyd, Breathitt, Clay, Elliott, Floyd, Harlan, Jackson, Johnson, Knott, Knox, Laurel, Lawrence, Lee, Lincoln, Leslie, Letcher, Magoffin, Martin, McCreary, Menifee, Morgan, Owsley, Perry, Pike, Pulaski, Rockcastle, Rowan, Wayne, Whitley, Wolfe, and parts of Bath, and Carter counties.
[6] Within the district are the economic leading cities of Ashland, Pikeville, Prestonsburg, Middlesboro, Hazard, Jackson, Morehead, London, and Somerset.
Much of the region now in the district strongly supported the Union in the Civil War, and identified with the Republicans after hostilities ceased.
Geographically, the district consists of flat land areas to the west, to Appalachia highland mountains to the east and southeast.
Until January 1, 2006, Kentucky did not track party affiliation for registered voters who were neither Democratic nor Republican.