The Ohio, which begins in Pittsburgh, has been a vital transportation route for over 15,000 years, used by prehistoric people and later by settlers heading west. Its ease of transport has driven industries and helped major cities, like Wheeling and Huntington, grow. It is especially noted for shipping materials like coal.

Geologically, the Ohio is young, formed during the last Great Ice Age, when glaciers blocked the ancient Teays River, forcing the water into its current path. Historically, it has faced problems with low water and severe flooding (like the record floods of 1936 and 1937).

To address these issues, engineers built 19 locks and dams (seven bordering West Virginia) to maintain a deep channel for barges and floodwalls to protect cities. Thanks to pollution control, the river is now cleaner than it used to be, supporting diverse fish and wildlife in its waters and on its many islands.