It starts at Mount Kamuro in the Ōu Mountains and flows in an easterly direction through the cities of Natori and Sendai.

[3] In the event of the river flooding, the dams serve to control and reduce water flow to lower basins.

[3] On the upper reaches of the Natori River, on the boundary between Miyagi Prefecture and Yamagata Prefecture, the river passes through a beautiful eight kilometer long ravine with cliffs, rock formations and pools called the Futakuchi-kyōkoku (二口峡谷).

The ravine contains the Akiu Great Falls, one of "Japan’s Top 100 Waterfalls", in a listing published by the Japanese Ministry of the Environment in 1990 and a nationally designated Place of Scenic Beauty.

[4] The ravine also contains the Banji (磐司岩, Banji-iwa), a monolithic cliff of tuff with a width of 150 meters and length of three kilometers, which has been eroded into vertical columns.