At Mengkarak, the river takes a turn toward northeast, passing through Chenor and then turning east at Lubuk Paku and Lepar into the floodplains of Paloh Hinai, Pekan and Kuala Pahang before draining into the South China Sea.

The Pahangese section covers the districts of Cameron Highlands, Lipis, Raub, Jerantut, Temerloh, Bera, Maran, Kuantan and Pekan; while the Negri section comprises the districts of Jelebu and Jempol.

The banks of the Pahang River were settled as early as 1400 by warriors and seafarers from around Maritime Southeast Asia including places such as Aceh, Riau, Palembang and Sulawesi.

[citation needed] During the Pleistocene epoch or Mesolithic period about 10,000 years ago, there was a 5 degrees celsius drop in the global temperature.

At mountaintops, snow accumulated as ice caps and glaciers (including Mount Kinabalu), thus disrupting the global hydrological cycle.

Mainland Asia, the Malay Peninsula, Sumatra and Java became connected to Borneo via the landbridge of exposed Sunda Shelf.

The town of Pekan, which is Pahang's royal capital, is situated on the southern bank of the river, near its mouth.