The river's main stem is entirely within Fresno County, and its watershed drains about 387 square miles (1,000 km2) of the southern Sierra Nevada mountain range.

It rises at an elevation of 11,380 feet (3,470 m) on the western border of the Sierra National Forest in an unnamed pond a mile (1.6 km) south of Mount Reinstein.

Shortly afterwards it receives Dinkey Creek, its largest tributary, from the right at Balch Camp, then turns south, flowing into the Kings River just northwest of Rodgers Crossing.

The Balch Powerhouse is one of the oldest hydro developments on the Kings River, originally completed in 1927 by San Joaquin Light & Power, a predecessor of Pacific Gas and Electric Company (PG&E).

Farmers feared that the federal plan would involve moving water south as part of the Central Valley Project, reducing what was available for local use.