The elktoe is found in the upper Mississippi drainage in the Ohio, Cumberland and Tennessee River systems as well as the Susquehanna River. In the Great Lakes region it is in the St. Lawrence drainage from Lake Huron to the Ottawa River. In general its range spans from western New York and Pennsylvania, west to Wisconsin, and south to northern Alabama.
In Michigan this species is found in rivers in both the upper and lower peninsulas, but may be absent from the coldwater rivers and streams in the northwest part of the state.
Biogeographic Regions: nearctic (Native )