Mill Creek is a 14.5-mile-long (23.3 km)[1] tributary of Opequon Creek, belonging to the Potomac River and Chesapeake Bay watersheds, located in Berkeley County in West Virginia's Eastern Panhandle.
Mill Creek is formed by a series of streams on the eastern flanks of North Mountain along Frog Hollow Road (Virginia Secondary Route 654) in northern Frederick County, Virginia.
Mill Creek crosses into Berkeley County, West Virginia, and continues its flow in a northerly direction along the eastern flanks of the mountain, parallel to County Route 51/2.
Along its course, Mill Creek is fed by a number of smaller spring-fed streams.
Mill Creek then turns to the northeast towards the historic hamlet of Gerrardstown, where it then meanders and heads east along Gerrardstown Road (West Virginia Route 51).