It is referred to as a "river of life" for the Kalinga people who live on its banks, and is well known among development workers because of the Chico River Dam Project, an electric power generation project which local residents resisted for three decades before it was finally shelved in the 1980s - a landmark case study concerning ancestral domain issues in the Philippines.

For centuries it has been central to farming, trading, livelihoods, and daily life, whether as a benefit or hindrance.

At times it might be an obstacle to settlements on the other side of the river, but until the last century this was an opportunity for enterprising Filipinos who would provide ferry transport.

The danger of flooding was less frequent due to being at a higher elevation than the bigger, flood-prone Cagayan into which it feeds.

It then flows northeastward through and next to cities and municipalities including Bontoc, Sabangan, Sadanga, Tinglayan, Lubuagan, Tabuk, Pinukpuk, Tuao, Piat, Rizal, finally arriving at Santo Niño, where it merges with the Cagayan River.