The river rises below Bells Hill and flows generally north by west, through the Cascade Dam, and reaches its mouth near Derby where it merges with the Ringarooma River.

[1] The river flooded in April 1929, following unusually heavy rains in northern Tasmania.

[2] After rainfall of 125 millimetres (4.9 in) in ninety minutes,[3] the Briseis Dam gave way upstream of Derby, causing a torrent of water to rush down the narrow gorge of the Cascade River.

At the time, the flood was the worst in Tasmanian history, lasting several days.

Thousands of buildings were damaged and the death toll is variously reported to be between 14 and 22.