Arising near Chetco Peak in the Klamath Mountains, it flows generally south to meet the Middle Fork Smith River at Gasquet, California.

[8] Sourdough Campground, undeveloped but open to dispersed camping in a meadow along the river, lies near the confluence of the North Fork with Baldface Creek in Oregon.

The remote campground, open all year, has five sites for tent or trailer camping, picnic tables, fire rings, a vault toilet, and limited parking, but no drinking water or garbage pickup.

[9] Lightly used by whitewater enthusiasts because it is difficult, remote, and often of insufficient flow for boating, the river is sometimes run for its lower 13 miles (21 km) in rafts or kayaks.

[3] In 2012, the Red Flat Nickel Corporation asked permission from the United States Forest Service to allow exploratory mining along the creek.