Middle Island Creek is a river, 77 miles (124 km) long, in northwestern West Virginia in the United States. It is a tributary of the Ohio River, draining an area of 565 square miles (1,463 km2) on the unglaciated Allegheny Plateau. It was named by late 18th century pioneering travelers on the Ohio River, who noted the location of the Creek's mouth opposite Middle Island in the larger river. In an artifact of nomenclature, it is often pointed out that Middle Island Creek is the longest stream in West Virginia bearing the name of "creek". Geography Course Middle Island Creek is formed at the community of Smithburg in Doddridge County by the confluence of Meathouse Fork and Buckeye Creek. It initially flows generally northwestward in a winding course through Doddridge and Tyler Counties, through the unincorporated community of Avondale and the town of West Union in Doddridge County; and in Tyler County, the unincorporated communities of Josephs Mills, Tyler, Blue, Frew, and Bridgeway, and the town of Middlebourne. From Middlebourne the creek turns to the southwest and flows roughly parallel to the Ohio River (excepting its numerous bends), through the unincorporated communities of Next, Little, Shiloh, and Falls Mills in Tyler County; and into Pleasants County, where it flows through the unincorporated communities of Arvilla, Sugar Valley, Union Mills, and DeLong and joins the Ohio River in the city of St. Marys. The lowermost of the creek are inundated by backup from the Willow Island Locks and Dam downstream on the Ohio River. In addition to the Meathouse Fork and Buckeye Creek, the largest tributaries of Middle Island Creek (ordered upstream to downstream) are Arnold Creek, which it collects on the boundary of Doddridge and Tyler counties; McElroy Creek, Indian Creek, Point Pleasant Creek, and Sancho Creek, each of which it collects in Tyler County; and Sugar Creek and McKim Creek, both of which it collects in Pleasants County. The Jug Middle Island Creek's most extreme meander forms a peninsula known as "the Jug," located upstream of Middlebourne. The creek rounds a 7-mile (11 km) bend only to return to within 100 feet (30 m) of itself. Sometime prior to 1800, a settler named George Gregg had a mill race carved across the narrow point of the peninsula and harnessed the resulting hydropower for a gristmill and sawmill. These were destroyed by a flood in 1852, while later mills were