Fall River County is located in south western South Dakota. It is named for the Fall River, which runs through it
Located in the southern edge of the Black Hills, the largest city and seat in the county is Hot Springs.
Fall River County borders Custer and Oglala Lakota Counties in South Dakota, as well as Niobrara County in Wyoming as well as Sioux and Dawes Counties in Nebraska.
Main highways through the county include US-18, US-385, SD-71, SD-79, SD-89 and SD-471
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