Bad Heart River's name is an accurate preservation of its native Cree-language name, maatsiti.

[2] It originates in Saddle Hills County of the Peace River Country, north of Sexsmith and south of Rycroft, at an elevation of 930 metres (3,050 ft).

After descending the slopes of the Saddle Hills, it is crossed by Highway 2, then flows north-eastward.

After being crossed by Highway 733, it continues eastward, receives the waters of Kakut Creek, then flows through a 150-metre (490 ft) deep canyon and empties into the Smoky River at an elevation of 435 metres (1,427 ft).

This article related to a river in Alberta, Canada is a stub.