Cryptobranchus alleganiensis alleganiensis (Eastern Hellbender) is a large, imperiled aquatic salamander found in rocky upland streams from New York to Alabama. Although widespread, many Hellbender populations are now highly fragmented by impoundments and degraded habitats. Hellbenders likely require specific stream habitats with relatively low anthropogenic impacts in order to maintain population viability. The Elk River is a small (5^th order), high-gradient tributary of the Watauga River drainage that originates in Avery County, NC and flows northwest to Watauga Reservoir in northeastern Tennessee. Although the Elk River's headwaters are heavily impacted by development in the resort towns of Banner Elk and Sugar Mountain; its lower reaches flow through portions of the Pisgah and Cherokee National Forests and over several large waterfalls before reaching the reservoir. Hellbender presence was undocumented in the Elk River prior to 2010. We learned that Hellbenders were likely present in the lower Elk River from anecdotal reports of sightings in Tennessee. In 2010 and 2011, we surveyed for Hellbenders at 10 sites in the Elk River drainage. We observed multiple size classes, including larvae and juveniles, present in the lower Elk River. Development in headwater regions of the Elk River in North Carolina may have caused habitat degradation in the upper Elk River causing the extirpation of Hellbenders in the upper reaches.