The southern end of this mountain range is 2.25 miles northwest of Kiefer in Allegany County.
It trends northeasterly, and ends about 1.5 miles south of the town of Emmaville in Fulton County.
Interstate 70 crosses Town Hill at a narrow angle to the mountain, following the ridge for four to five miles as it slowly climbs one side and descends the other.
Part of Buchanan State Forest lies on Town Hill in Fulton County.
South of the Potomac River in Hampshire County, West Virginia, Town Hill rises to a height of 1,306 feet (398 m).