Sewell Mountain in Fayette and Greenbrier counties is a part of the dissected Allegheny Plateau that was uplifted from the sea during the mountain-building period known as the Appalachian Orogeny, millions of years ago. The rock formations are sedimentary. Shale is more abundant and sandstone the most important in landform development, but coal is the mineral of economic importance.

From an elevation above the New River Gorge at about 2,200 feet, Sewell Mountain increases eastward over the next 10 to 12 miles to 3,200 feet elevation. At this point Sewell Mountain appears as a ridge about three-quarters of a mile wide and eight miles long. It extends in a northeast to southwest direction, capped with sandstone knobs (Busters, Myles, Stevens, Ford, and others) that top out at 3,460 feet. From the top, the ridge descends rapidly to the valleys of Sewell Creek and Meadow River. Sewell Mountain is neighbored to the south, east, and north by Walnut Ridge (3,223 feet), Fork Mountain (3,309 feet), Sims Mountain (3,282 feet), Little Sewell Mountain (3,000 feet), and Laurel Creek Mountain (3,063 feet). Sewell Mountain is drained westward primarily by Glade Creek through Babcock State Park to the New River at the now defunct coal and coke town of Sewell.

In the Sewell Mountain Campaign in 1861, Gen. Robert E. Lee established his headquarters on the summit, and it was here that he first saw Traveller, the great war horse he later purchased for $200 in Confederate currency. Mining in the Sewell coal seam began in the 1870s as railroads penetrated the region. Underground shaft and drift mines 400 to 500 feet deep and surface contour stripping at about 2,800 feet were common mining methods during the next century. In 1910, the Raine brothers established the Meadow River Lumber Company and the town of Rainelle at the confluence of Sewell Creek and Meadow River. To supply the mill, which was capable of cutting 3,000 acres of virgin timber a year, they acquired more than 75,000 acres of timber, much of it in the Sewell Mountain region. The Meadow River Lumber Company logged Sewell Mountain until it closed in 1970.

In the mid-1700s, Stephen Sewell explored the region and his name was later given to a coal seam and a company town, and to Sewell Creek, Sewell Mountain, Big Sewell Mountain (3,212 feet) in Summers County, and Little Sewell Mountain. The early route over Sewell Mountain followed a meandering buffalo trail that became known as the Lewis Trail in 1774. In 1824, the route became a part of the James River & Kanawha Turnpike, and a section of the Midland Trail in 1924 when it was designated U.S. 60. Traffic was diverted from the Sewell Mountain region when I-64 was completed in 1988, and U.S. 60 has been designated as the Midland Trail Scenic Highway. Sewell Mountain remains a scenic delight, with active farming communities, verdant second-growth forest, and varied topography.