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- Oconee County, Georgia: Oconee is named for the Oconee River that forms part of the county's border
- Ohio County, Indiana: Ohio is named for the Ohio River.
- Ohio County, Kentucky: Also named for the Ohio River. When the county was formed, the river formed its northern boundary, but no longer does after several new counties were carved from it.
- Ohio County, West Virginia: Also named for the Ohio River.
- Ontonagon County, Michigan is named for a river called Nantounagon on an early French map.
- Otter Tail County, Minnesota: Otter Tail is named after Otter Tail Lake and Otter Tail River. The river was named by the Ojibwa for its long sandbar shaped like an otter's tail.
- Osage County, Kansas: Osage is named for the Osage River.
- Oswego County, New York: Oswego is named for the Oswego River.
- Ouachita County, Arkansas: Ouachita is named for the Ouachita River.
- Ouachita Parish, Louisiana: named for the Ouachita River
Read more about this topic: List Of U.S. Counties Named After Rivers