From 1834 to 1854 the river was paralleled by the Allegheny Portage Railroad, connecting the two branches of Pennsylvania Main Line Canal, with the western terminus of the portage railroad at Johnstown. On May 31, 1889, a dam on the South Fork holding back a 3 mi (5 km) long reservoir failed, sending a wall of water down the Little Conemaugh at 40 mph (64 km/h) and up to 60 ft (18 m) high, resulting in the loss of over 2,200 lives in one of the worst disasters in U.S. history (see: Johnstown Flood).
The river flows through scenic mountainous areas but is considered severely degraded by abandoned mine drainages--most notably, the Hughes bore hole--from the long exploitation of the region's coal resources. The recovery of the river is an ongoing project of federal, state, and private agencies.