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The North Fork Kentucky River is approximately 125 miles long. It rises on the western side of Pine Mountain, in the Appalachians of extreme southeastern Kentucky, in eastern Letcher County near the Virginia state line. It flows generally northwest, in a winding course through the mountainous Cumberland Plateau, past Hazard and Jackson. It receives Rockhouse Creek at Blackey near its source. Approximately 8 mi southeast of Hazard, it receives the Carr Fork. It receives Troublesome Creek at Haddix, southeast of Jackson. Three miles upstream from its confluence with the South Fork, it receives the Middle Fork. It joins the South Fork to form the Kentucky at Beattyville.