Built in 1905, the Grand Lodge on Fifth was originally constructed as an Elks Home by the Benevolent and Protective Order of Elks, a fraternal order which was founded in Paducah in 1891. The rectangular plan lodge building is embellished with classical architectural details: stone quoins on the first story corners, keystoned lintels over the third story windows, Ionic-capitaled brick pilasters, and a dentilated and modillioned cornice at the roofline. The entablature is treated with molded terra cotta swags and garlands that encircle and connect round attic story windows. The interior rooms likewise reflect the grandeur of a bygone era, with hardwood floors, decorative pressed tin ceilings, plaster walls, fifty-five expansive double hung windows, and a grand staircase made of solid oak.
The Grand Lodge on Fifth is one of only two surviving structures built specifically for use by fraternal organizations in nineteenth century Paducah. Many notable Paducahans – among them Vice-President of the United States Alben Barkley and humorist Irvin S. Cobb – were members of the Elks. The building is listed on the National Register of Historic Places.