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 is the longest stream in the state bearing the name of "creek" and is named for Middle Island, located in the Ohio River at its mouth.
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