[1] It is a tributary to the Salmon River, and lies in the center of the 2.5-million-acre (3,900 sq mi; 10,000 km2) Frank Church-River of No Return Wilderness Area.

[2] Given Federal protection in 1980, the wilderness area it lies within is part of the largest roadless tract left in the lower 48 states.

The Middle Fork flows through 2,500 square miles (6,500 km2) of rugged terrain known as the Salmon River Mountains, peaks of which reach 10,000 feet (3,000 m).

An example would be that they must have a fire pan and some sort of portable human waste containment system (groover, WAG BAGs, etc.).

During his second summer in office in 1978, President Jimmy Carter and his family vacationed in the West in the latter half of August, which began with a three-day, seventy-mile (110 km) float trip down the Middle Fork of the Salmon.