The Kentucky River is formed in eastern Kentucky at Beattyville, in Lee County, by the confluence of the North, Middle and South Forks at about 670 feet (200 m) elevation, and flows generally northwest, in a highly meandering course through the mountains, through the Daniel Boone National Forest, then past Irvine and Boonesborough, then southwest, passing south of Lexington, then north through Frankfort. It joins the Ohio at Carrollton.
Approximately 15 miles (24 km) southwest of Boonesborough it is joined by the Red River. Approximately 20 miles (32 km) southwest of Boonesborough it is joined by Silver Creek. At High Bridge, it is joined by the Dix River. At Frankfort, it is joined by Benson Creek. Approximately 10 miles (16 km) north of Frankfort, it is joined by Elkhorn Creek.
Between Clays Ferry in Madison County and Frankfort, the river passes through the Kentucky River Palisades, a series of dramatic steep gorges approximately 100 miles (160 km) in length.
It continues on till it flows into the Ohio River at Carrollton in Carroll County.
According to Robert F. Collins of the United States Forest Service, Dr. Thomas Walker named the river the Louisa River in 1750, after Princess Louisa, the wife of Prince William, Duke of Cumberland (Walker had just named the Cumberland River a month or two earlier). Over time the name Louisa became Levisa and shifted to the nearby stream today called the Levisa Fork.
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