You can start this loop at either the Elk Creek Trailhead or the Kings Mountain Trailhead and you can go clockwise or counter-clockwise (although counter-clockwise is more popular as it has you ascending Elk Mountain as opposed to descending it). To save the 3.5 mile Wilson River Trail return, you could do a car shuttle.
The trail is is steep and rugged in many spots. The trail off the summit of Elk Mountain is a bit exposed and can be challenging in winter conditions. Along the traverse to Kings Mountain there is a fixed line in one place to protect on particularly exposed section.
This trail is not for the beginner hiker.