Later, Kate married a dentist by the name of Silas Melvin and the couple had a child. However, both husband and child passed away in the same year.

By 1874 Kate was said to have been in Wichita, Kansas and later she was working in a sporting house for Nellie Bessie Earp the wife of James Earp. Though Kate always stated that she did not meet Wyatt Earp until she was in Fort Griffin, Texas, she and Wyatt Earp were in Wichita at the same time, and it has been speculated that she had a relationship with Wyatt at that time.

In 1875 she was going by the name of Kate Elder and was listed as being in Dodge City, Kansas working as a dance hall girl. A couple of years later she moved south to Fort Griffin, Texas, she met Doc Holliday at John Shanssey’s Saloon, where Holliday was dealing cards. By this time, Kate had earned the nickname "Big Nose” Kate. While the dance hall girl and prostitute was attractive, she did have a prominent nose. Kate was tough, stubborn, and with a temper that matched Doc’s. She said she worked the business because she liked it, belonging to no man, nor to any house!

Kate would spend the next several years with Holliday, traveling to Kansas, Colorado, South Dakota and New Mexico. Their relationship was often rocky, with Kate still plying her trade as a prostitute from time to time.

While still in Fort Griffin in 1877, Doc was dealing cards to a local bully by the name of Ed Bailey, who was accustomed to having his own way without question. Bailey was unimpressed with Doc’s reputation and in an attempt to irritate him; he kept picking up the discards and looking at them. Looking at the discards was strictly prohibited by the rules of Western Poker, a violation that could force the player to forfeit the pot.

Though Holliday warned Bailey twice, the bully ignored him and picked up the discards again. This time, Doc raked in the pot without showing his hand, nor saying a word. Bailey immediately brought out his pistol from under the table, but before the man could pull the trigger, Doc’s lethal knife slashed the man across the stomach. With blood spilled everywhere, Bailey lay sprawled across the table.