The Ossipee River begins at the village of Effingham Falls, New Hampshire, at the outlet of Berry Bay, the farthest downstream of a chain of lakes connected to Ossipee Lake.

The river, flowing east, forms the border between the towns of Effingham and Freedom.

[2] Entering Maine, the river continues to serve as a municipal boundary, first between Porter and Parsonsfield, and then between Hiram and Cornish.

Kezar Falls, a village in the town of Porter, forms a significant community along the river, with two dam impoundments.

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