It discharges into Pictou Harbour which is a sub-basin of the Northumberland Strait.

It is an estuary for approximately 12 km (7.5 mi) from Pictou Harbour to New Glasgow and is currently navigable for small pleasure craft for approximately 10 km (6.2 mi).

The lower valley, running approximately 20 km (12 mi) from Pictou Harbour experiences the majority of human impact.

The valley is tied to Nova Scotia's, and Canada's, earliest industrial activity since the discovery in 1798 of what is now known as the Pictou Coalfield in the Carboniferous Stellarton Basin.

[1] The nation's first steel fabrication facility was founded in 1872 in Trenton, spurred in part by the availability of local coal and partly by the transportation opportunities provided by the navigable portion of the river and the arrival in 1867 of the Nova Scotia Railway.