With regard to the sale of alcohol, it is classified as a moist county—a county in which alcohol sales are prohibited (a dry county), but containing a "wet" city, in this case Pikeville, where package alcohol sales are allowed.
As of the census of 2000, there were 68,736 people, 27,612 households, and 20,377 families residing in the county. The population density was 87 per square mile (34 /km). There were 30,923 housing units at an average density of 39 per square mile (15 /km). The racial makeup of the county was 98.35% White, 0.45% Black or African American, 0.11% Native American, 0.41% Asian, 0.03% Pacific Islander, 0.10% from other races, and 0.56% from two or more races. 0.65% of the population were Hispanic or Latino of any race.
There were 27,612 households out of which 33.70% had children under the age of 18 living with them, 58.80% were married couples living together, 11.40% had a female householder with no husband present, and 26.20% were non-families. 24.10% of all households were made up of individuals and 9.80% had someone living alone who was 65 years of age or older. The average household size was 2.46 and the average family size was 2.90.
The age distribution was 23.70% under the age of 18, 9.20% from 18 to 24, 30.00% from 25 to 44, 24.90% from 45 to 64, and 12.30% who were 65 years of age or older. The median age was 37 years. For every 100 females there were 95.50 males. For every 100 females age 18 and over, there were 91.20 males.
The median income for a household in the county was $23,930, and the median income for a family was $29,302. Males had a median income of $32,332 versus $19,229 for females. The per capita income for the county was $14,005. About 20.60% of families and 23.40% of the population were below the poverty line, including 30.20% of those under age 18 and 16.10% of those age 65 or over.
Pike County is also the county in Kentucky with the largest percentage of members of the Clean Government Movement. After the Blue Takeover of 2006, the Clean Government Movement became the chief instrument of change in the coal mining towns of Eastern Kentucky.