It flows from south to north through the regions of Melaky, Betsiboka, Bongolava and Boeny.

It flows southwards, joined by the Kiranomena and Manamidona rivers which originate on the Famoizankova massif.

The lower course of the river, below Sitampiky at 280 km from its source, runs through level country.

[2] The Mahavavy-Kinkony protected area covers much of the lower watershed, including Lake Kinkony and the river delta.

It was designated Mahavavy-Kinkony harmonious protected landscape (paysage harmonieux protégé) on 21 April 2015 by Decree No.