The creek flows from the lake in a southeasterly direction, roughly parallel to New York State Route 224, past Alpine Junction and the hamlet of Cayuta.

It then crosses into Chemung County and flows through the village of Van Etten.

At Van Etten, the creek turns southward and runs through the western edge of Tioga County.

It flows through Lockwood and Reniff in the town of Barton, and through the eastern part of the village of Waverly, where it passes beneath the Southern Tier Expressway.

Immediately south of the highway, the creek crosses into Pennsylvania in the borough of Sayre.