The Sengoku period warlord Takeda Shingen built extensive dikes along the Kamanashi portion of the river, which allowed water to flood buffer zones to control damage.

Flood control efforts continued under the Tokugawa shogunate of the Edo period, when extensive dikes were completed in 1674 after 50 years of construction, to divert the lower river away from populated areas, which were prone to flooding.

Water transportation up the river from Suruga Bay to inland Kai Province prospered in the Edo period and early Meiji period, until the opening of the Tōkaidō Main Line, Chūō Main Line and Fuji Minobu Railway railways.

There are numerous dams for hydroelectric power generation and flood control along the various tributaries in the upper reaches of the river.

[2] The view of the Tōkaidō Shinkansen train crossing the river against the background of Mount Fuji is a celebrated scene representative of Japan.