[citation needed] The river flows through Chittar, Vadasserikkara, Ranni, Ayroor, Cherukole, Keezhukara, Kozhencherry, Maramon, Aranmula, Arattupuzha, Edanad, Puthencavu, Chengannur, Kallissery, Pandanad, Parumala, Mannar, Kadapra, Melpadom, Thevery, Veeyapuram, Thakazhy, Pullangady, Pallathuruthy before emptying into the Vembanad Lake, while another branch flows directly via Karuvatta into Thottappally Spillway.

The coast for a short distance along the borders of lakes is flat, retreating from it the surface roughens up into slopes which gradually combine and swell into mountains on the east.

[citation needed] Due to drought and a lack of conservation and protection by the government, the Pampa River has shrunk to a stream and is totally dry in many places.

[2] The Kerala High Court has initiated steps to control the pollution of the river from the practice of some visitors to Sabarimala who throw their clothes into it.

[3] As part of the Punyam Poonkavanam project, pilgrims have been exhorted to avoid the usage of soap and oil while bathing in River Pamba.

Bathing in the river, believed to absolve one's sins, is a requirement before commencing the trek through the forest to the Ayyappan Temple atop Sabarimala.