Cold Water Creek rises about 0.5 miles northeast of China Grove, North Carolina, and then flows southeast and south to join Irish Buffalo Creek about 3 miles northeast of Flows Store.

[2] Cold Water Creek drains 64.06 square miles (165.9 km2) of area, receives about 46.9 in/year of precipitation, has a wetness index of 397.40, and is about 41% forested.

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