Though never the bedrock of the region as it is in parts of Kentucky and West Virginia, coal has caused fortunes to be made and lost, livelihoods to be earned and shattered.
It's a boom or bust industry, a hard scrabble living.
"There's nothing romantic about the coal business, although country music singers try to blow it up. It's a tough business," the late Gordon Bonnyman told me some 15 years ago, when he was serving as chairman of Blue Diamond Coal Co.
The business hasn't gotten any easier.
As News Sentinel business editor Bill Brewer points out, coal prices are again rising and mining activity is increasing. The current upswing stems from increased worldwide demand, particularly from fast-developing countries such as China and India.
Price increases, however, are offset by increased costs in fuel and equipment, as well as increasingly tougher environmental regulations. It's a situation that leaves the few remaining players still struggling to make money.
Little coal mined in East Tennessee stays in the region - TVA currently burns primarily a lower-sulfur variety - but it remains an important domestic fuel source for electricity. Concerns about its environmental effects, and particularly the economic impact of those effects, are very real, too - from the ozone-depleting emissions created from burning coal to the scars to the scenery left from mining it.
Balancing those concerns won't be easy, and never has been. As the push continues to find cost-effective means to power the country, a seat at the table needs to be reserved for coal.