Elizabethton

At the SR 359/Milligan Highway exit, US 321/SR 67 continues on into Elizabethton as Elk Avenue on a 4-lane undived highway through commercial areas, where they become concurrent with SR 91 (Elizabethton Highway) and have an intersection with SR 362 (Gap Creek Road). US 321/SR 67/SR 91 then parallels the Watauga River before passing by a reconstructed interpretation of Fort Watauga at Sycamore Shoals State Park. The highway then passes through more commercial areas before entering downtown, where it becomes Broad Street and has an intersection with SR 400 before crossing the Doe River along the historic Broad Street Bridge and coming to an intersection with US 19E/SR 37 (Highway 19E), where SR 91 splits off and goes north along US 19E/SR 37 while US 321/SR 67 turns south along US 19E/SR 37.

The concrete arch
Broad Street Bridge.

Further on south, the four-laned highway crosses over the Doe River for a second time and then runs closely parallel with it. US 19E/US 321/SR 37/SR 67 starts gaining some gradual elevation and eventually crosses a series of bridges over the Doe River at the Valley Forge community just outside of the Elizabethton city limits (a left turn off SR 67 and onto Beck Moutanin Road after the first bridge is an alternative route to both the TVA Watauga Dam and the TVA Wilbur Dam).

SR 67 completes a final fourth and curving high double bridge crossing before arriving at Hampton.

Hampton

At Hampton, SR 67 and US 321 split off from the US 19E/SR 37 concurrency and continue eastward. Here, the road begins as a two-lane segment, briefly passing by commercial areas in Hampton (including a U.S. post office, a Dollar General store and a non-attended public vehicle parking area for Appalachian Trail hikers arriving or entering the "AT" at Hampton), and then exiting Hampton over a high ridge.

Watauga Lake

Upon leaving Hampton, US 321/SR 67 again continually increases in elevation and roughly runs for several miles parallel to the shoreline of the massive Watauga Lake, through the Cherokee National Forest. Watauga Dam can be seen in the distance across the reservoir at the Rat Branch Boat Launch. At Fish Springs, SR 67 splits off from US 321, which heads east along SR 159, and veers northeastward, crossing Watauga Lake at the 80-foot (24 m) high Butler Bridge before entering Johnson County and Butler.