[3] The upper Ngaruroro drains the Kaweka Forest Park and it is used for trout fishing (mostly rainbow),[4] rafting, tramping and deer hunting.

This aquifer feeds several streams in the area (e.g. Raupare, Irongate), in addition to pumping that supports extensive orchards of the Heretaunga Plains.

[7] The Ngaruroro is one of several rivers that helped form the alluvial Heretaunga Plains at the south end of the coast of Hawke Bay.

In 1969, the bottom four kilometres (2.5 mi) of river was diverted more directly to the coast (near Pakowhai Road) in an effort to reduce flooding.

The river breached its flood banks during Cyclone Gabrielle in February 2023, inundating a large area of the Heretaunga Plains.