Gospel musician Ethel Caffie-Austin was born in Bluefield on February 11, 1949. She was raised in Mount Hope, Fayette County, by her parents Lucy and Dave "D. C." Caffie. Her father—a coal miner, minister, and guitarist—insisted that his child learn music. Ethel was playing piano at age six, accompanying her father during his services at the Word of Truth church when she was nine, and directing youth choirs by 12. She took lessons in Mount Hope from Eunice B. Fleming, the first Black person ever to give a master's recital (1957) and perform at a commencement (1973) at Marshall University.

After graduating from Mount Hope High School in 1967, Caffie's father discouraged her from pursuing a music career, primarily for financial reasons. Instead, she earned an English degree from the West Virginia Institute of Technology and taught that subject in public schools for 20 years. She did perform in the college choir but worried her gift for playing and singing the blues was drifting too far from her gospel roots. So, she formed The Collegiate Gospel Choir of West Virginia Tech. The choir director resented her side group and banned music majors from participating, which just made her ensemble all the more popular on campus. At one point, about 40 students sang in her "underground gospel" group, as she called it.

In 1971, she took the group to perform at the women's federal prison at Alderson. The warden was so impressed she hired Caffie as an intern to teach both gospel and secular music. The warden even allowed her to take the gospel group on the road for concerts.

In 1976, Caffie moved to Charleston to take a job with Multi-CAP, an anti-poverty program. She began teaching piano to children in Charleston's public housing projects and formed yet another choir, which grew to between 70 and 80 young people. In 1979, she accompanied two busloads of children to attend the Rev. James Cleveland's Workshop of America in Washington, D.C., and sing at Constitution Hall. Reflecting later on this time, she said, "It was important for me to be able to reach those people who love the music but didn't get to hear it that frequently."

In 1982, Caffie married James Austin, who died from an enlarged heart in 1989, about the time her career began to gain momentum.

Ethel Caffie-Austin performed with her group Christ Inspiration Delegation at the Port Townsend Folk Festival in Washington state and toured several times in Europe, and later in Zimbabwe. She also became a fixture at Charleston's Vandalia Gathering, giving stirring performances and leading gospel workshops. In the 1990s, she performed at the Kennedy Center in Washington, D.C., founded the Black Sacred Music Festival at West Virginia State College (now University), received an honorary Doctor of Arts degree from Davis & Elkins College, recorded two songs at the Barns of Wolf Trap for The Harry Smith Connection: A Live Tribute to the Anthology of American Folk Music (1998), and was the subject of a 1999 Kentucky Educational Television (KET) documentary His Eye Is on the Sparrow. In addition, she recorded her own CDs and the instructional videotape Learn to Play Gospel Piano, released by Homespun on a two-DVD set and now available online for download.

In the 21st century, Caffie-Austin has continued to perform regularly and receive recognition for her work. In 2006, the state Department of Arts, Culture & History bestowed upon her West Virginia's highest folklife honor, the Vandalia Award. She was inducted into the West Virginia Music Hall of Fame in 2020. For her many accomplishments, she has earned the title "West Virginia's First Lady of Gospel Music."