It is approximately 4.9 miles (7.9 km) long and flows through Carbondale Township and the boroughs of Mayfield and Archbald.

The creek tends to be slightly acidic, but its iron, manganese, and aluminum concentrations do not need reduction to meet its total maximum daily load requirements.

At the southern end of the lake, the creek turns southwest for more than a mile, briefly passing through Mayfield and entering Archbald.

A few tenths of a mile further downstream, it passes through Aylesworth Creek Lake and continues flowing west-northwest before crossing US Route 6 and turning southwest.

[1] Aylesworth Creek joins the Lackawanna River 24.30 miles (39.11 km) upriver of its mouth.

A total of 0.6 miles (0.97 km) of one of the unnamed tributaries is impaired, with the cause being flow alterations and the source being abandoned mine drainage.

The concentration of manganese in the creek at this site is 0.15 milligrams per liter and the load is 11.4 pounds (5.2 kg).

The aluminum concentration is 0.26 milligrams per liter and the daily load is 19.8 pounds (9.0 kg) per day.

However, a 92 percent reduction in acidity is needed to meet the total maximum daily load requirements.

[4] Near its mouth, iron and aluminum in Aylesworth Creek were not detected in the total maximum daily load study.

[1] The watershed of Aylesworth Creek is in the Appalachian Mountain section of the ridge and valley physiographic province.

However, the lower reaches of the creek have been impacted by past mining operations and urban development.

Most of the upper reaches of the watershed are on Pennsylvania State Game Lands or private property.

The United States Army Corps of Engineers constructed a flood protection project on Aylesworth Creek in the 1970s.

In 2000, a stream stabilization project was carried out in the creek's lower reaches to reduce bank erosion.

[3] An abandoned mine drainage mitigation project is located in the watershed of Aylesworth Creek.

It consists of two limestone water wheels the revolve in two concrete basins and neutralize the flow of acid mine drainage into Aylesworth Creek Lake.

However, the system eventually entered a state of disrepair and in 2006 it was replaced by an anoxic limestone drain for $191,000.

This project will regrade culm and mine waste, reduce erosion, and increase alkalinity.

This area is known as the Powder Mill Dam River Corridor Preserve and the creek spends its last 0.2 miles (0.32 km) within it.

[3] Silverbrook Anthracite Inc. #35910102 is the only active surface mining permit in the Aylesworth Creek Watershed.

Since the operation does not involve water, a treatment system, an NPDES permit, and a Waste Load Allocation are not necessary.