[5] The North Fork supports populations of cutthroat trout and steelhead suitable for sportfishing.

Bank access is good where land owners allow it, but anglers often prefer drift fishing from boats.

Watercraft can be launched from near bridge crossings and taken out above the rapids at Culvert Hole, about 5 miles (8 km) from the river mouth.

[6] The North Fork Smith Trail, open all year, runs along the North Fork for 6.5 miles (10.5 km) through a forest of old-growth Douglas firs to Lower Kentucky Falls along Kentucky Creek.

[8] Named tributaries of the North Fork Smith River from source to mouth are Jump, Sheep Herder, and Kentucky creeks.