The New River rises on Frozen Head, a notable mountain of Morgan County, Tennessee named for its frequent winter appearance and the focal point of a Tennessee State Park and Natural Area. Draining an area of Pennsylvanian Period rock that has been subjected to extensive strip mining for coal, the upper reaches of the stream have at times been subject to heavy pollution. The stream initially trends northeast. The upper portion of the course is paralleled by State Route 116. It soon crosses into a remote area of Anderson County, and then into Campbell County. At this juncture, State Route 116 turns to the southeast, and the road paralleling the New River becomes a small county road. The stream trends generally north from this point for several miles, and is also paralleled by a railroad constructed primarily for the purposes of coal transport.