It begins at Lake Okeechobee at the S-2 water control structure in South Bay west of Belle Glade, Florida.
When it reaches the more heavily built-up region further east, it bends to head due eastward, forming the county line.
Near its eastern end at the Intracoastal Waterway, with Boca Raton to the north and Deerfield Beach to the south, it departs from its straight course to go around several curves, but the county boundary continues to follow it at this point.
Before 1921 the Hillsboro River, one of several "deep streams" in present-day Broward County, was an outlet for sheet flow, allowing freshwater runoff to leave the eastern Everglades.
By 1921 the canal was complete; it proved almost too effective, economically ruining coastal truck farms, and led to saltwater intrusion.