It flows northward towards Cagayan de Oro for about 90 kilometres (56 mi)[5] before emptying into Macajalar Bay.

[5] About 80% of the drainage basin is located in the Province of Bukidnon and the rest is in Iligan and Cagayan de Oro.

[7] The jump-off point of the river, whitewater rafting is at Barangay Mambuaya, a 30-40 minute ride from the city proper.

Inaugurated in August 2023, the Cagayan de Oro River flood management project was financed by the Japanese International Cooperation Agency.

The boulevard's "Tree of Life" historical marker was installed at Isla De Oro along the CDO river as memorial to the mango shelter for 50 natives during the 2011 typhoon Tropical Storm Washi.

In the lower reaches of the stream, this low catch of smaller immature fish is evidence of lack of management of the fishery.