Elkhorn Creek derives its name from the distinctive elk-horn shape formed by its North and South Forks, which converge just east of Frankfort at the historic Forks of Elkhorn. From this confluence, the main stem flows approximately 13-18 miles northward through Franklin County before emptying into the Kentucky River near Still Waters Campground. The creek carves through ancient limestone palisades, creating dramatic bluffs and rock formations that tower above the water, while dense sycamore canopies and exposed Devonian-era geology add to the creek's distinctive character.

The paddling experience on Elkhorn Creek ranges from exhilarating whitewater to gentle family floats. The upper section from Forks of Elkhorn to Church's Grove offers the most challenging water—the renowned "Palisades" or "Gorge Float"—featuring Class II-III rapids that approach Class IV during high flows. This 4.8-mile stretch includes notable features like the Jim Beam Distillery low-head dam (requiring mandatory portage on river left), Hawk Hole's deep pocket beneath towering cliffs, and Indian Head Rock. Downstream from Church's Grove through Knight's Bridge and Peaks Mill, the creek mellows to Class I-II, ideal for intermediate paddlers and anglers. The final stretch from Peaks Mill to the Kentucky River confluence provides the gentlest water, perfect for beginners and families.

Elkhorn Creek is renowned for exceptional smallmouth bass fishing, with recent population surveys showing some of the highest catch rates since the mid-1990s. Anglers also target channel catfish, rock bass, spotted bass, and largemouth bass. The clear waters support diverse wildlife including great blue herons, kingfishers, bald eagles, deer, and various snake species along the banks.

Spring and early summer offer optimal paddling conditions when rainfall maintains adequate flows (300-800 cfs recommended for most sections). The creek is rain-dependent and can become too shallow during droughts or dangerously high after heavy storms. Multiple access points serve paddlers: AMA on the Creek at Forks of Elkhorn (paid parking), Church's Grove VPA #3, American Whitewater Access near Knight's Bridge, T.N. Sullivan WMA, Peaks Mill VPA, and Peter W. Pfeiffer Fish Hatchery.

Walt Whitman immortalized the creek in "Song of Myself," and the waterway inspired development of the Kentucky Reel, America's first multiplying fishing reel, crafted by Frankfort artisans in the 1800s. Historic sites include remnants of Stedman Mill (a Civil War-era paper manufacturer) and various distillery operations along the banks.

Critical safety considerations include the deadly Jim Beam low-head dam less than one mile below Forks of Elkhorn, rapidly changing water levels during storms, and the need to monitor USGS gauge readings before launching. Commercial outfitters like Canoe Kentucky provide rentals, shuttles, and guided trips ranging from 2-hour family floats to full-day gorge adventures.