Across the coalfields of West Virginia, Kentucky, and Virginia, mining companies have spent two decades blasting the tops off mountains to reach thin seams of coal, dumping the rubble into adjacent valleys. The film lays out the scale of that practice: more than a million acres of Appalachian forest destroyed or damaged and nearly 2,000 miles of streams buried under mining debris. Footage moves between active blast sites, flattened ridgelines now used as scrubland or industrial parkland, and the hollows below where residents describe wells running black and flood patterns changing after nearby valley fills went in. Miners, company representatives, scientists, and local families all get time on camera, giving both the economic case for surface mining and the ecological and health costs communities say they are paying. The film treats mountaintop removal as a regional transformation already well underway rather than a hypothetical threat, tracking what has already been lost and what is still being cleared as the practice continues.