The bulk of Our Southern Highlanders is based on observations Kephart made while at Hazel Creek (1904–1907), although several chapters added in 1922 were based on events that occurred later when Kephart lived in Bryson City. Chapters 9 ("The Snake-Stick Man") and 10 ("A Raid into the Sugarlands") were based on events that occurred in 1919. Chapter 11 ("The Killing of Hol Rose") was based on events that occurred in late 1920.
Chapter I, "Something Hidden; Go and Find It," discusses the remoteness and ruggedness of the Southern Appalachian Mountains, the lack of realistic literature regarding its inhabitants, and gives a brief history of the region.
Chapter II, "The Back of Beyond," gives a description of Medlin and discusses how the mountaineers have adapted to their environment, the difficulties in farming the rugged terrain, and grazing in the highland meadows.