The parks begin at the upstream end of the Ohio River, Pittsburgh, Pennsylvania, river mile 0. They continue in order downstream to the confluence with the Mississippi River at Cairo, Illinois, 981 miles later. Parks are listed in order by river mile.

As of this date, September 2015, 82 parks have been identified. Not all of them are yet posted.

River mile locations of major cities and metropolitan statistical areas are as follows:

001 Pittsburgh, Pennsylvania

044 East Liverpool/Salem Ohio, 062 Weirton, West Virginia, 068 Steubenville, Ohio, 091 Wheeling, West Virginia, 172 Marietta, Ohio, 184 Parkersburg, West Virginia, 265 Point Pleasant, West Virginia, 309 Huntington, West Virginia, 322 Ashland, Kentucky, 354 Portsmouth, Ohio

471 Cincinnati, Ohio

604 Louisville, Kentucky

757 Owensboro, Kentucky, 793 Evansville, Indiana, 934 Paducah, Kentucky, 981 confluence with Mississippi River