The trail follows along the North Sylamore Creek, a federally designated scenic river, from which it is named. Hikers will encounter a wide variety of forested landscapes ranging from lower streamside elevations to high ridges. Main points of interest include Slick Rock Hollow, numerous scenic overlooks, and beautiful open fields managed as openings for wildlife. In addition to the original 13.75 mile section, the trail now extends from Barkshed Campground, upstream along the creek to a new trailhead on Cripple Turkey Road where it intersects the Ozark Highlands Trail. The ten mile extension was completed in 2006, largely through the efforts of the Ozark Society and American Hiking Society in cooperation with the U.S. Forest Service. Three trailheads are located within the District’s developed recreation areas: Blanchard Springs, Gunner Pool, and Barkshed. Camping is available only within developed sites at the recreation areas, but primitive camping is allowed at the Allison and Cripple Turkey Trailheads. With caution, the access roads for the extension can be negotiated in almost any vehicle. The roads are gravel, narrow, rough, and not populated or heavily traveled. Cole Fork Road is subject to flooding, and caution should always be used crossing Cole Fork Creek near the end of the road.