It originates from the confluence of Beech Nursery Creek, off the western slope of Mount Mitchell, and Blue Sea Creek, off the northeastern slope of Blackstock Knob, in the Black Mountains.

Since the project's completion in October 2016, the Cane River has been dam free.

[11] In 2008, the Burnsville Wastewater Treatment plant malfunctioned and spilled fecal coliform bacteria that was considered dangerous for human contact.

The ecological damage from the incident had impacted the wildlife downstream from the wastewater plant, including the Appalachian elktoe.

[12] While improvements have been made to the wastewater facility, concerns remain after any heavy rain that the Yancey County Health Department issues precautionary advisories.