Via the Ohio, it is part of the watershed of the Mississippi River, draining an area of 2,320 mi2 (6,009 km2)[3] on the unglaciated portion of the Allegheny Plateau.

It served as an important commercial water route in the early history of West Virginia, particularly in the logging and petroleum industries.

[2][4] The Little Kanawha rises in southern Upshur County, approximately 20 mi (32 km) south of Buckhannon.

It follows a meandering course generally west-northwestwardly, through Lewis, Braxton, Gilmer, Calhoun, Wirt and Wood Counties, past the communities of Burnsville, Stouts Mills, Sand Fork, Glenville, Grantsville, Bigbend, Creston, Burning Springs, Palestine, Elizabeth, and Newark, to its mouth at the Ohio River in Parkersburg.

[8] According to the Geographic Names Information System, the Little Kanawha River has also been known as:[9] Multiple West Virginia stage record fish were caught along the Little Kanawha River.