[1]: 3 The river overflows during monsoons, at times across thousands of hectares of fertile plains of Jhapa.

The Kotihom Surunga Municipality holds an annual Mai Mela fair on Magh 1 (January 14), where people from Jhapa, Morang, Ilam, and various parts of India come to enjoy and perform religious activities.

A holy river for many Hindus living nearby, the Kotihom (eastern) riverbank is a common site for death rituals.

The cremation service Kankai Aryaghat was funded by public investment and built on the Kotihom bank of the river.

The Kankai is a rainfed perennial river whose primary tributary, the Mai Khola, originates in the Mahabharat Range in eastern Nepal.

The Kankai is a gravelly river with more than 60% of its gravel being gneiss, and the rest consisting of different metamorphic and sedimentary rocks.

A detailed feasibility study of the project was completed in 1970 with technical assistance from the Asia Development Bank (ADB).

[7] After the completion of the second phase of the project, financial assistance from ADB ceased and in 1993 the Kankai Development Board, formed in 1973 for the implementation of the construction works, was dissolved.

The canal network crosses many flashy rivers, hence many cross-drain structures (siphons) have been built in the system.

Erosion of banks and inundation during rains cause problems for the residents of its catchment area near Satasidham and Panchganchi village development committees.

[9][needs update] The Kankai River in Jhapa is a famous pilgrimage site, attracting devotees from Nepal and India.