It flows from headwaters in the Sierra Madre Occidental to the Pacific Ocean in the Gulf of California.

It flows generally southwest for a distance of 290 kilometres (180 mi),[1] with its river mouth on the Gulf of California at Lechuguilla Island, 43 kilometres (27 mi) west of the city of Los Mochis.

Miguel Hidalgo Dam impounds the river near the town of El Fuerte creating the state's largest reservoir, Embalse de Gustavo Diaz Ordaz.

[2] The water is used extensively for agricultural irrigation in northern Sinaloa and southern Sonora states.

The river is surrounded by large mango plantations which produce the fruits mainly for export to the United States.