Abstract Heat flow values were calculated from direct measurements of temperature and thermal conductivity at thirteen sites in the Arkansas-Missouri Ozark Plateau region. These thirteen values are augmented by 101 estimates of heat flow, based on thermal conductivity measurements and temperature gradients extrapolated from bottom-hole temperatures. The regional heat flow profile ranges from 9 mW m −2 to over 80 mW m −2, but at least two distinct thermal regimes have been identified. Seven new heat flow determinations are combined with three previously published values for the St. Francois Mountains (SFM), a Precambrian exposure of granitic and rhyolitic basement rocks, average 47 mW m −2. Radioactive heat production of 76 samples of the exposed rocks in the SFM averages 2.4 μW m −2 and a typical continental basement contribution of 14 mW m −2 is implied. Conversely, the sedimentary rock sequence of the plateau is characterized by an anomalously low heat flow, averaging approximately 27 mW m −2. Groundwater transmissivity values that are based on data from 153 wells in deep regional aquifers demonstrate an inverse relationship to the observed heat flow patterns. The areas of high transmissivity that correspond to areas of low total heat flux suggest that the non-conservative vertical heat flow within the Ozark sedimentary sequence can be attributed to the effects of groundwater flow.