[4] Whitewater kayaking experts sometimes run a 4-mile (6.4 km) stretch of rapids in a steep canyon between the Cook–Underwood Road bridge and Drano Lake.

[5] Named rapids include Gettin' Busy, Boulder Sluice, Island, Sacriledge, Double Drop, Backender, S-Turn, Wishbone, Bowey's Hotel, The Gorge, Stovepipe, Spirit Falls, Chaos and Master Blaster.

In its upper reaches, it flows generally south through the Gifford Pinchot National Forest before turning southwest, receiving Beetle Creek from the right and entering Skamania County.

In a narrow canyon paralleled by Cook–Underwood Road on both sides of the river for the next stretch, the stream receives Rock, Squaw, and Bunker creeks, all from the right.

At the end of the canyon, the river passes through the Little White Salmon National Fish Hatchery and enters Drano Lake, 163 miles (262 km) from the Columbia's mouth on the Pacific Ocean.