To create a printable, nice looking trail elevation profile, I use Google Earth to generate the path profile, and the Gimp + Inkscape to design it, but you can use any bitmap and vector image editing software you like.
Open the desired trail in Google Earth. Right-click and select Show Elevation Profile.
Depending on trail distance, and how wide you want the elevation profile to be, resize the Google Earth window to be wider. Turning off the Sidebar (View > Sidebar) is also helpful. If you have a dual-monitor setup, it’s easier to get a wider profile, but even with a single monitor, you can resize the window, drag it partially off the screen, resize it again, etc., until you have the desired size.
Next, create screenshots of each part of the profile. You’ll need at least a couple to get rid of the vertical marker. Put your mouse on a different area of the profile during each screenshot so that when they are combined, you will have a clean section to cover up with.
Then, open them in the Gimp to crop and combine them. Export a jpg or png image.
Open the image in Inkscape. Right-click the image and select Trace Bitmap. This converts the bitmap to a vector image that can be scaled without losing quality, providing nice clear printouts even at large sizes.
There are a number of options for tracing the bitmap. For this project, Brightness Cutoff worked well with the Threshold around 0.450, leaving only the path profile line.
Click OK to trace the bitmap. Delete the image if you’re happy with the trace.
From there, you can use Inkscape to create the rest of the path profile however you like. Add an outline, fill the inside with a color or gradient.
Start adding trails and various features along the trail. I refer back to Google Earth for placement along the profile. You can move your mouse along the path profile to determine the approximate spot where a particular point of interest should be placed in Inkscape.
Continue adding camps and other items of interest. Some you might consider are an elevation grid, water sources, side trails, etc. When you’re all finished, you can export a PDF for printing, or a PNG for viewing online or using elsewhere.
View some completed elevation profiles here.