Via the Alapaha and Suwannee rivers, its waters flow to the Gulf of Mexico.

The river rises on the boundary between Lowndes and Echols counties at the confluence of Grand Bay Creek and Mud Creek, about 10 miles (16 km) southeast of Valdosta.

The river flows southeast through Echols County, crossing into Hamilton County, Florida, around 2 miles (3 km) above its confluence with the Alapaha River near the town of Jennings.

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