Black Elk was born in December 1863 along the Little Powder River (thought to be in the present-day state of Wyoming). According to the Lakota way of measuring time, (referred to as Winter counts) Black Elk was born "the Winter When the Four Crows Were Killed on Tongue River".
When Black Elk was nine years old, he was suddenly taken ill and left prone and unresponsive for several days. During this time he had a great vision in which he was visited by the Thunder Beings (Wakinyan), and taken to the Grandfathers — spiritual representatives of the six sacred directions: west, east, north, south, above, and below. These "...spirits were represented as kind and loving, full of years and wisdom, like revered human grandfathers." When he was seventeen, Black Elk told a medicine man, Black Road, about the vision in detail. Black Road and the other medicine men of the village were "astonished by the greatness of the vision"
Black Elk had learned many things in his vision to help heal his people. He had come from a line long of medicine men and healers in his family; his father was a medicine man as were his paternal uncles. Late in his life as an elder, he related to John Neihardt the vision that occurred to him in which among other things he saw a great tree that symbolized the life of the earth and all people. Neihardt recorded all of it in minute detail, and consequently it is preserved in various books today.
In his vision, Black Elk is taken to the centre of the earth, and to the central mountain of the world. What mythologist Joseph Campbell explained as "the axis mundi, the central point, the pole around which all revolves...the point where stillness and movement are together..." Black Elk was residing at the axis of the six sacred directions. Campbell viewed Black Elk's statement as key to understanding myth and symbols.