The Little Sioux River is integral to the Nepper Watershed Project, a major Iowa flood control and soil conservation program that was introduced in 1947.

It then traverses a rich agricultural region on its way to the Loess Hills, from which it then flows out onto the floodplain of the Missouri River.

Through much of its middle course (i.e., from Linn Grove to Smithland) the Little Sioux is a relatively wild meandered stream, with excellent canoeing, camping, and fishing opportunities.

Correspondingly, hunters are rewarded with a bounty of white-tailed deer, rabbits and pheasants during the fall hunting season.

Edible gamefish such as bullhead and channel catfish are frequently caught with nothing more than a hook and worm, with northern pike, walleye, and shovelnose sturgeon also available.