The Ok Tedi Mine is located near the headwaters of the river, which is sourced in the Star Mountains.

Nearly the entirety of the Ok Tedi runs through the North Fly District of the Western Province of Papua New Guinea, but the river crosses the international boundary with Indonesia for less than one kilometre.

The roar from the river can be heard for many kilometres through the dense jungle of the district.

The pristine river was devastated by the Ok Tedi environmental disaster, when the enormous open-pit copper/gold Ok Tedi mine discharged massive amounts if mining waste directly into the river.

Until its seizure by the Government of Papua New Guinea, the mine was owned by BHP.