A part of the Surma-Meghna River System, the Meghna is formed inside Bangladesh in Kishoreganj District above the town of Bhairab Bazar by the joining of the Surma and the Kushiyara, both of which originate in the hilly regions of eastern India as the Barak River.

The Meghna empties into the Bay of Bengal in Bhola District via four principal mouths, named Tetulia (Ilsha), Shahbazpur, Hatia, and Bamni.

The Meghna is formed by the confluence of the Surma and Kushiyara rivers originating from the hilly regions of eastern India.

After Chandpur, the combined flow of the Padma, Jamuna, and Meghna moves down to the Bay of Bengal in an almost straight line, braiding occasionally into a number of riverines including the Pagli, Katalia, Dhonagoda, Matlab, and Udhamodi.

[citation needed] Near Bhola, just before flowing into the Bay of Bengal, the river again divides into two main streams in the Ganges delta and separates an island from both sides of the mainland.