Its source is Monte Carpegna, which is in the Montefeltro part of the province of Pesaro e Urbino.

[1] The river flows northeast near Macerata Feltria and Mercatino Conca before crossing into the province of Rimini.

[2] The river then flows past Morciano di Romagna before entering the Adriatic Sea southeast of Misano Adriatico and northwest of Cattolica.

In later centuries, the valley was frequently contested by the Byzantines, Goths, and Lombards, then by the Papal States and various empires controlling Romagna, and more recently in territorial changes between the Province of Rimini and the Province of Pesaro and Urbino.

[3] During World War II, the British and their allies defeated the Germans in a battle near the Conca.