Known as "The City That Moves Mountains," Pikeville stands as the economic and cultural center of eastern Kentucky. The city earned this nickname from the Pikeville Cut-Through, an engineering marvel that rerouted the Levisa Fork River and railroad to prevent downtown flooding. This ambitious project symbolizes the city's progress and development.

Rental options in Pikeville include apartments near the University of Pikeville campus and residential neighborhoods with townhomes and single-family rentals. Downtown residents are within walking distance of the Appalachian Wireless Arena and the Appalachian Center for the Arts. The Weddington Square area features shopping centers and healthcare facilities, while neighborhoods along Chloe Road and Thompson Road offer rentals with mountain views.

The Pikeville Medical Center, a Mayo Clinic Care Network affiliate, serves as one of the area's major employers alongside the University of Pikeville, which includes colleges of osteopathic medicine and optometry. The city sits at the intersection of US-23 and US-460, approximately three hours from Lexington. Recreation opportunities include the Hatfield and McCoy River Trails and Breaks Interstate Park, nicknamed the "Grand Canyon of the South."