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Back Creek is a tributary of the Potomac River that flows north from Frederick County, Virginia to Berkeley County in West Virginia's Eastern Panhandle. Back Creek's source lies along Frederick County's border with Hampshire County, West Virginia at Farmer's Gap in the Great North Mountain.
Back Creek's headwaters lie at Farmer's Gap in Great North Mountain. From its source, the creek flows northwest along the western edge of Burnt Ridge off the mountain. It turns towards the northeast and the shallow stony stream makes its way along the western flanks of Great North Mountain with White Pine Ridge bounding it to its west. Back Creek is joined by a series of mountain streams including Reed Creek and Lauren Run, both flowing off Great North Mountain. At Dunlap Ford, Back Creek is joined to its west by Gallows Ridge and to its east by Cove Ridge. There, it is also joined by Laurel Run which carries the spring waters from Rock Enon Springs from the east. Capper Ridge bounds Back Creek to its west at Pooles Ford as it makes its way towards Gore. This region on the western flanks of Great North Mountain is rich in sandstone and sand deposits, hence the sand mines at Gore. At Gore, Back Creek is joined by Mine Spring and Dry Runs.
From Gore, Back Creek flows parallel to the south of the Northwestern Turnpike (U.S. Highway 50) and the Winchester and Western Railroad. It flows under US 50 along Bowling Green Ridge where it turns east towards Gainesboro, the site of its confluence with Tavenner Run. From Gainesboro, Back Creek flows beneath the North Frederick Pike (U.S. Highway 522). At Grave Hill, north of Lew, Back Creek is joined by its two major tributaries: Isaacs Creek and Hogue Creek. From its fork with Hogue Creek, the stream is bounded by Hunting Ridge to its east. By its confluence with Brush Creek at Baileys Ford, Back Creek is a large stream with increased water flow with depths up to a few feet. Back Creek meanders northward through the community of De Haven at Warm Springs Ford. Shortly after its horseshoe bend at De Haven, Back Creek flows into Berkeley County, West Virginia.
Once Back Creek has made its way into West Virginia, North Mountain's western flank adjoins the stream, feeding it with numerous spring streams. Through Berkeley County, Back Creek flows through an expansive valley. It continues north around the community of Glengary, under West Virginia Route 45, and around Ganotown. North of Ganotown, after its confluence with Tub Run, Leading Ridge forms the western edge of Back Creek's valley. It meanders northeast through the community of Shanghai. From Shanghai, Back Creek is continued to be fed by spring streams off North Mountain. With North Mountain bound it to its east, Back Creek continues northeast by several more communities including Tomahawk, Hedgesville, and Soho. Northeast of Soho, Back Creek is joined by another of its major tributaries, Tilhance Creek. After flowing beneath the Baltimore and Ohio Railroad mainline bridge, Back Creek meanders to the northeast north of Allensville before finally emptying into the Potomac River.