The complex drainage systems within karst settings can result in atypical longitudinal profiles. Features, such as cave entrances, can be expressed as anomalous ‘bumps’ in the longitudinal profile of a stream if downcutting has continued upstream of the area in which the water is pirated to the subsurface. Horn Hollow, a fluviokarst valley located in Carter Caves State Park Resort in northeastern Kentucky, was examined for these types of features. The objectives of this study were to determine if sediment mobility can be used as a proxy for anomalous areas along the profile of the valley and if detailed cross-sections can reveal and/or differentiate areas of cave collapse from natural down-cutting of the system. To accomplish these objectives, the longitudinal profile of Horn Hollow and numerous cross-sections through the valley were surveyed. Armor point counts were performed at cross-sections unless the section was predominantly bedrock. Although Horn Hollow’s waters have been predominantly pirated to the subsurface, the longitudinal profile of the system is graded to that of a stream near equilibrium, but anomalous areas are present. The progression of sediment size along the length of the profile does not follow a typical fining-downstream pattern. Some of the largest sediments can be found within the lower segment of the profile. Taken together, the anomalous bumps and the sediment size suggest that the shape of the longitudinal stream profile is strongly influenced by karst processes such as stream piracy and cave collapse.