It is Kentucky's third largest banking center, with financial institutions and holding companies with more than $1 billion in assets.

The Appalachian News Express, published in Pikeville, is preserved on microfilm by the University of Kentucky Libraries.

The microfilm holdings are listed in a master negative database on the university's Libraries Preservation and Digital Programs website.

The county's population centers include Pikeville and its surrounding suburbs, Elkhorn City, and the unincorporated town of South Williamson.

The zip codes 41502 (Pikeville), 41503 (South Williamson), and 41527 (Forest Hills) are the wealthiest portions of the county.

South Williamson and Forest Hills are located on the Northeast side of the county.

[23] The office of Pike County Judge Executive served as a launching pad for the governorship of Paul E. Patton (1995–2003).

This was a bipartisan effort led by a citizens' group, Pike Countians Against Government Waste, that garnered signature petitions in 2015–16 to place the question on the ballot.

In March 2017, the fiscal court, composed of six magistrates and a judge-executive, voted unanimously to sue the judge-executive (who voted to sue himself) to overturn the results of the ballot question to change the form of government.

The fiscal court, composed of magistrates Jeff Anderson, Vernon "Chick" Johnson, Leo Murphy, Hilman Dotson, and Bobby Varney and Judge Bill Deskins, was first represented by Assistant County Attorney John Doug Hays and then by County Attorney Howard Keith Hall.

Pike County has vast fossil fuel, (coal and natural gas) reserves.

In 2010, the Pikeville Medical Center received a $44 million loan from the U.S. Department of Agriculture Rural Development program to construct an 11-story office building and adjacent parking garage downtown.

[42] The following lists of middle and elementary schools are categorized by the high school they feed: Shelby Valley Day Treatment Center, Phelps Day Treatment Center, are all discipline facilities.

Northpoint Academy is a high school dropout prevention program that focuses on the students' individual needs.

In 2012 and 2013 Pikeville Junior High baseball finished second in the Kentucky Middle School State Tournament.

In 2010, the American Basketball Association opened an expansion franchise in Pikeville called the East Kentucky Energy.

In 2010, Shelby Valley High School won the KHSAA Men's Basketball State Championship.

In 2011, UPike Men's Basketball won the national championship, defeating Mountain State University.

In 2010, it was announced that the Pike County Crusaders, an Indoor Arena Football team, were coming to the Eastern Kentucky Expo Center, but the initiative failed.