Its headwaters are in the mountains of Impasugong, Bukidnon, south of Gingoog in Misamis Oriental, where it is called the Pulangi River.

Flowing out of the mountains, it forms the center of a broad, fertile plain in the southcentral portion of the island.

Before its mouth in Illana Bay, it splits into two parallel sections, the Cotabato and Tamontaka, separated by a 180 m (590 ft) hill.

The river has recently been clogged with water hyacinths, causing it to overflow after days of heavy rain.

President Benigno Aquino III ordered public works and military personnel to clear the river of up to 20 hectares (0.20 km2) of water lily growth.