The river is by Lonesome Point, Old Iliamna and Pile Bay Village.

While no road connects the local communities to Alaska's road and highway system, a road connecting Williamsport, Alaska on Iliamna Bay along the Alaskan coast to Pike's Bay on Lake Iliamna provides an important transit route for boaters.

The 15-mile road enables a shortcut for fishing vessels crossing from Cook Inlet and landing in Williamsport.

The 320-mile route is an alternative to a 1,000-mile journey around the Alaska Peninsula.

[3] In 2016, a historic truss bridge over the river was offered for free to anyone that wanted it and could remove it as construction on a replacement was initiated.