[2] It flows between rolling uplands dotted with commercial plantations, passing under the Kruger Bridge of 1898, before reaching Pivaansbad south of Paulpietersburg, where hot springs and the Natal Spa resort are located.

Downstream it enters open but hilly terrain until it enters the Bivane Dam, where the Bivane Dam resort and a nature reserve of 2,000 ha are located.

This area is also the starting point for the annual Ithala Challenge Canoe Marathon.

[3] The river has a confluence with the Pongola on the western boundary of the Ithala Game Reserve, not far from the border with Eswatini.

The Bivane Dam was completed in 2000 at its confluence with the Manzana River, to provide for a local irrigation scheme.