The river extends from a largely forested headwater region through alpine, sub-alpine, boreal foothills, and aspen parkland ecoregions, to a predominantly agricultural mid-region of improved pasture with dispersed cattle grazing and accompanying forage crop production, and thereafter through the city of Calgary under the influence of the urban environment.

From there, it flows northward through residential communities towards the city centre, is crossed by Macleod Trail, passes the Calgary Stampede grounds and finally joins the Bow River west of the Wilder Institute/Calgary Zoo.

Dominant vegetation in the upper Elbow River drainage basin includes trembling aspen (Populus tremuloides), balsam poplar (P. balsamifera), lodgepole pine (Pinus contorta) and white spruce (Picea glauca).

Soils in the Elbow watershed are primarily black chernozemics, orthic gray luvisols, eutric brunisols, and coarse loam overlying glaciofluvial gravels (Mitchell and Prepas 1990).

Land use in the upper Elbow watershed is centered primarily on recreation, including camping, hiking, biking, equestrian, and some limited off-road vehicle activity.

[3] In June 2013, Alberta, Canada, experienced heavy rainfall that triggered catastrophic flooding throughout much of the southern half of the province along the Bow, Elbow, Highwood and Oldman rivers and tributaries.

A dozen municipalities in Southern Alberta declared local states of emergency on 20 June as water levels rose and numerous communities were placed under evacuation orders.