Elena Karamihaylova was one of the first women artists in modern Bulgaria. She graduated from Robert College in Istanbul in 1895, then in 1895-1896 she studied painting at the Vienna Art Academy for Women. At the invitation of the Robert College she taught there in 1898-1899, then continued her artistic education in Munich, in private schools and at the Academy of the Society of Women Artists. She returned to Bulgaria and settled in Sofia in 1910.

E. Karamihaylova chose to not found a family in order to devoted herself entirely to artistic activities. During the rule of the Communist government, the remarkable house in Sofia where she lived with her brother’s family (the surgeon Dr Ivan Karamihaylov), was turned into the residence of the Union of Architects in Bulgaria.
E.Karamihaylova created portraits, figurative compositions and flower still lives. Her models were often family members, among them her sister Magda (Portret na sestra mi Magda [Portrait of my sister, 1910] and Pred ogledaloto [In Front of the Mirror, 1912], both in the Elena Karamihailova Gallery in Shumen). The stylistic features of her painting can be related to the variety of late Impressionism as practised in Munich’s artistic circles. At the same time, some elusive evocations are achieved through the visual effects of white luminosity, together with allegorical compositions, such as Optimizǎm [Optimism, 1919] and Prolet II [Spring II, 1920], poeticizing the relationship between mother and child, recalling Symbolist experience. In the last years of her artistic career, she spent summers in the village of Zemen, not far from Sofia. She painted peasant women, children and landscapes in a kind of illustrative plein-air mode.

In 1951 she was awarded the title Merited Artist and he is included in all historical accounts of modern art in Bulgaria. The city gallery in her home town was named after her. During her lifetime E. Karamihaylova participated in major exhibitions in Bulgaria and abroad, among them the International Art Exhibition in Rome in 1911, the Lada Society of South Slavic Artists exhibitions in Zagreb (1908) and Belgrade (1912) and Sto godini bǎlgarsko izkustvo (1820-1920) [100 Years of Bulgarian art (1820-1920), Sofia, 1935]. Since her death, exhibitions of E. Karamikhaylova’s work have been organised by the Elena Karamihaylova Gallery in Shumen and the Union of Bulgarian Artists, and her work can be found in the gallery in Shumen, the National Gallery, and the Sofia City Art Gallery, as well as other public galleries in Bulgaria and in private collections.