We assessed outdoor recreation and tourism trends for Canaan Valley (hereafter, the Valley) and Tucker County, WV, from historical and contemporary perspectives. Using various primary and secondary sources, including academic research papers, agency reports, newspaper articles, and personal interviews, we developed a socio-demographic profile of Tucker County to gain a context for understanding the issues associated with outdoor recreation and tourism in the region. We then developed a historical model to outline discrete stages of outdoor recreation and tourism development in the Valley. We identified critical issues, such as the lack of coordination and level of conflict, then formulated sustainable development options for the Valley and its environs. Two specific strategies towards sustainable development include (1) the creation of a Canaan Valley Coordinating Council and (2) the County's active participation in regional heritage- and nature-based tourism initiatives. Tourism development should be part of a broad economic diversification strategy, not just a replacement for a traditional boom-and-bust, resource-based economy.