The Deschutes provided an important route to and from the Columbia for Native Americans for thousands of years, and then in the 19th century for pioneers on the Oregon Trail.

The river flows mostly through rugged and arid country, and its valley provides a cultural heart for central Oregon.

Today the river supplies water for irrigation and is popular in the summer for whitewater rafting and fishing.

The Deschutes flows generally north, as do several other large Oregon tributaries of the Columbia River, including the Willamette and John Day.

[7] In central Bend, the river enters Mirror Pond, an impoundment behind Newport hydroelectric dam.

As it heads north through the central Oregon high desert, the river carves a gorge bordered by large basalt cliffs.

Further downstream are Swamp, Skookum, Oak, Antoken, Cove, Eagle, Nena, Wapinitia and Bakeoven creeks.

The dam has been owned by Pacific Power since 1930 and still produces electricity that supplies approximately 400 Bend households.

[15][16] In 1964, on the Deschutes River, Portland General Electric (PGE) built, what was at the time, the largest hydroelectric dam in Oregon.

[18] It is home to Columbia River redband trout (Oncorhynchus mykiss gairdneri) known locally as "redsides".

[20] They are abundant in this stretch of the river,[clarification needed] which has counts of 1,700 fish of 7 inches in size per mile[21] (1,100 fish of 18 centimeters in size per kilometer) above Sherar's Falls, and they are noticeably stronger than trout who do not have to cope with life in such a big, powerful river.

Fishing for them is most popular from Warm Springs down to Macks Canyon (Warm Springs Reservation owns the entire Deschutes west bank from 16 miles (26 km) south of Maupin to Lake Billy Chinook and on up to Jefferson Creek on the Metolius River arm) below Pelton Dam.

These insects are in the river year-round; however their large adults are a major food source for the fish: artificial weighted stonefly nymph patterned tied flies are a staple for Deschutes anglers year round.

Other fish found in Crane Prairie are brook trout, kokanee salmon, largemouth bass, black crappie, tui chub, three-spined stickleback, and whitefish.

[25] Fly, lure, and bait fishing are popular methods, with the majority of trout fisherman casting or trolling in the channels.

[24] For the best chance of catching large fish, a boat or other flotation device is recommended as the channels can be wide and deep.

Vertical jigging in an aggressive manner can be an effective method of targeting the salmon species of the reservoir.

The upstream section known as the Big Eddy is a short segment upriver from the city of Bend between Dillon and Lava Island falls.