The February 7, 1812, New Madrid, Missouri, earthquake (M [moment magnitude] 8) was the third and final large-magnitude event to rock the northern Mississippi Embayment during the winter of 1811–1812. Although ground shaking was so strong that it rang church bells, stopped clocks, buckled pavement, and rocked buildings up and down the eastern seaboard, little coseismic surface deformation exists today in the New Madrid area. The fault(s) that ruptured during this event have remained enigmatic. We have integrated geomorphic data documenting differential surficial deformation (supplemented by historical accounts of surficial deformation and earthquake-induced Mississippi River waterfalls and rapids) with the interpretation of existing and recently acquired seismic reflection data, to develop a tectonic model of the near-surface structures in the New Madrid, Missouri, area. This model consists of two primary components: a north-northwest–trending thrust fault and a series of northeast-trending, strike-slip, tear faults. We conclude that the Reelfoot fault is a thrust fault that is at least 30 km long. We also infer that tear faults in the near surface partitioned the hanging wall into subparallel blocks that have undergone differential displacement during episodes of faulting. The northeast-trending tear faults bound an area documented to have been uplifted at least 0.5 m during the February 7, 1812, earthquake. These faults also appear to bound changes in the surface density of epicenters that are within the modern seismicity, which is occurring in the stepover zone of the left-stepping right-lateral strike-slip fault system of the modern New Madrid seismic zone.