It empties into an estuary and tidal marshland on Willapa Bay.

One of the first documented cases occurred at the mouth of the Bone River.

A homesteader named James Swan witnessed the disease breaking out among the Chinook Indians after several ships had wrecked off the mouth of the nearby Columbia River.

[3] Part of the river's drainage basin is a protected land preserve called the Bone River Natural Area Preserve.

Totaling 2,565 acres (1,038 ha), the preserve contains the finest salt marsh remaining in Willapa Bay and is a critically important waterfowl habitat.