Stretching west from the Blue Ridge for approximately 55 miles (89 km) is the Ridge and Valley region, in which numerous tributaries join to form the Tennessee River in the Tennessee Valley. This area of Tennessee is covered by fertile valleys separated by wooded ridges, such as Bays Mountain and Clinch Mountain. The western section of the Tennessee Valley, where the depressions become broader and the ridges become lower, is called the Great Valley. In this valley are numerous towns and two of the region's three urban areas, Knoxville, the 3rd largest city in the state, and Chattanooga, the 4th largest city in the state. The third urban area, the Tri-Cities, comprising Bristol, Johnson City, and Kingsport and their environs, is located to the northeast of Knoxville.

Approximately how many miles long is Tennessee's Ridge and Valley region?