It is the primary outflow of Lake Ōhau, from which it flows in a roughly eastward direction until reaching the artificial Lake Benmore after a distance of roughly 27 kilometres (17 mi).

In 1981, the artificial Lake Ruataniwha was created along the river's length to power a small hydroelectric power station as part of the Waitaki hydro scheme.

[2] The river forms part of the traditional boundary between Otago and Canterbury regions.

[3] Prior to European settlement of the region, the river was a traditional mahinga kai (food gathering site) for Māori travelling through the Mackenzie Basin, providing valuable food sources such as weka, tuna (eels), and pora (Brassica rapa subsp.

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