It originates at the toe of the Thompson Glacier[2] in the Premier Range of the Cariboo Mountains, west of the community of Valemount.

The North Thompson passes by several small communities, the most notable being Blue River, Clearwater, and Barriere.

The Clearwater River drains much of Wells Gray Provincial Park.

About 17.4 kilometres (10.8 mi) upstream from the small town of Avola, the North Thompson River is forced through a narrow chute only about 30 feet (9.1 m) wide, creating a rapid that resembles the Fraser's famous rapid.

Many river rafting companies offer a variety of trips through the rapids.