The Ohio River Islands National Wildlife Refuge was established in 1990 to protect, conserve, and restore habitat for wildlife native to the river's floodplain. The refuge is important in conserving the "wild" Ohio within one of our nation's busiest inland waterways. Refuge islands are gradually returning to forested conditions after years of farming, oil and gas extraction, and other activities. The refuge works to protect wildlife and habitats native to the Ohio River and its floodplain. Migratory birds and endangered freshwater mussels are among the important wildlife emphasized on the refuge.

The refuge consists of twenty-two islands and four mainland tracts scattered along 362 miles of the upper Ohio River. Most of the refuge's 3440 acres of land and underwater habitat are located in West Virginia; however, Pennsylvania and Kentucky each have two refuge islands.

Hiking trails are available around the refuge visitor center in Williamstown, WV and on Middle Island in St. Marys, WV. An auto tour is also available on Middle Island. Boating and fishing are allowed around all refuge islands during daylight hours. Shore fishing access is also available at the visitor center and Middle Island. Hunting is allowed with a permit on most refuge property. Educational programs are available by request.