There are picturesque white limestone cliffs flanking a number of stretches of the Bolshoy Patom.

The river flows first in an approximately western direction across the highland area within a gorge cut into the plateau bedrock.

Near the slopes of the northern end of the Kropotkin Range it bends and flows roughly northwards with many rapids.

The river channel widens and the flow slows down in its last 250 km (160 mi) stretch across a wide floodplain.

Finally the Bolshoy Patom meets the right bank of the Lena near at the border of the Sakha Republic (Yakutia), 2,334 kilometres (1,450 mi) from its mouth.