From Camerons Flat onwards, the river is increasingly braided until it passes through a narrow gorge and under the West Wanaka bridge just before Lake Wānaka.

The present landscape was shaped by glacial processes during the ice ages, when huge glaciers filled and scoured out the valleys.

The historic Māori iwi (tribes) of Kāti Māmoe and Ngāi Tahu both had named settlements around the shores of Lakes Wānaka and Hāwea, including Nehenehe on the northern banks of the mouth of the Matukituki River, which they called "Mātakitaki".

[3] Ngāi Tahu kaumātua recorded Mātakitaki as a kāinga mahinga kai (food-gathering place) for tuna (eels), kāuru (cabbage tree root), and aruhe (bracken fernroot).

Above the tree line, at about 1,100 metres (3,600 ft), stunted, sub-alpine shrub land gives way to alpine tussock grasslands and fell fields.

Paradise shelduck thrive on the river flats, and in summer, spur-winged plover and oystercatchers are a common sight on farmland and along the drive from Wānaka.