The river is relatively untouched by modern development, and is mostly surrounded by wetlands of cypress and tupelo with the adjacent higher lands mostly used for conventional agriculture or tree farming.

The lower region is a deep tidal river, navigable by colonial-era ships to the former community of Willtown (later called Black Mingo, near Rhems), about halfway up the length of the creek.

The decision by the state in 1811 to build the creek bridge for the main north-south road about a mile downstream of Willtown accelerated the village's decline.

Charles Flint Rhem (January 24, 1901 – July 30, 1969), born in Rhems, South Carolina, was a professional baseball player and pitcher for the St. Louis Cardinals (1924–28, 1930–32, 1934 and 1936), Philadelphia Phillies (1932–33) and Boston Braves (1934-35).

[citation needed] He helped the Cardinals win the World Series in 1926, 1931, and 1934, and the National League Pennants in 1928 and 1930.