It then flows to the west through Clark County until it converges with the Lewis about 3.5 mi (5.6 km) upstream from the Columbia River.

When George B. McClellan was on the Northern Pacific Railroad Survey in 1853, he logged information in his journals about his visit to the Yacolt area, including the East Fork Lewis River.

[5] The East Fork Lewis River begins on the west slope of Green Lookout Mountain, in the southwest corner of the Gifford Pinchot National Forest in Skamania County.

With the presence of these brittle materials combined with its steep gradient, it experiences high levels of erosion, contributing to the sediment deposits downstream.

[6] Many varieties of trout and salmon live and spawn in the East Fork, including Chinook, coho, chum, and steelhead.

In 2014, the East Fork was designated as a wild steelhead gene bank by the Washington State Department of Fish and Wildlife.