SR 10 makes some wild moves as it makes its way through Matoaka and then meets SR 71 at the Eastern end.

The town was originally founded around 1793 as part of the Virginia Colony and was finally incorporated over 100 years later, around 1912, as part of West Virginia. The common story it derived its name from the secret name for Pocahontas, daughter of Chief Powhatan. The Matoaka station on the rail line has been demolished and freight trains no longer stop at the town leading to a sharp decrease in business. There is still an old red caboose that sits on Barger Street, but the rest of that street, which had once been the main business street, consists of boarded up or abandoned two and three story buildings lining both sides of the street.