Via Sandy Creek and the Tuscarawas, Muskingum and Ohio Rivers, it is part of the watershed of the Mississippi River, draining an area of 187 square miles (484 km²), including the city of Canton.

[2] Nimishillen Creek flows on both glaciated (in the north) and unglaciated (in the south) portions of the Allegheny Plateau,[6] in Stark and Tuscarawas Counties.

[2][6] From Canton, Nimishillen Creek flows generally southwardly, past East Sparta, into northern Tuscarawas County, where it flows into Sandy Creek from the north.

According to one tradition, the name "Nimishillen" is derived from a Native American word meaning "black alder".

[10] According to the Geographic Names Information System, Nimishillen Creek has also been known historically as:[1]