Once regulatory approval has been confirmed, the operator will be allowed to offer customers on-premise, online and mobile wagering at the Grand Falls Casino Resort in Larchwood, Iowa.
The Iowa Gaming and Racing Commission (IGRC) approved Betfred Sports Iowa last week.
Iowa became the third state in 2019 to legalise sports betting after Governor Kim Reynolds signed SF 617 into law.
Last month, Betfred reported a £40.7m ($51.8m) loss after tax for the 12-month period ending 30 September 2018.
Fred Done, CEO and Co-founder of Betfred, said: “I’m delighted to partner with Elite Casino Resorts in Iowa and we look forward to working with our new partners and sharing our joint expertise in what is a very exciting opportunity and market for Betfred.”