It drains a rural area of forested foothills and a farming valley north of the city of Spokane along the Idaho–Washington border.

It rises in southern Pend Oreille County, south of Newport near the Idaho state line.

It flows south-southwest past the communities of Elk, Milan, Chattaroy, Buckeye, Colbert, Dartford and Fairwood.

The non-native fish species listed by Washington Department of Ecology are brook trout, brown trout, grass pickerel, pumpkinseed, green sunfish, largemouth bass, tench, yellow bullhead, and yellow perch.

In 1893, the ichthyologists Charles Gilbert and Barton Warren Evermann reported extensive damage to the Little Spokane as a result of human activities:[4]