It is formed by the springs of the eastern slope of the Sierra Madre Oriental, and along its course towards the Gulf of Mexico it receives the waters of numerous tributaries in the Sierra Norte of Puebla.

Due to the great rainfall in this river basin, during the rainy season it usually suffers floods, some of which have caused great social disasters.

In October 1999, the Pantepec River swept away several houses in the municipality of Huehuetla, Hidalgo, and 254 people in the state of Puebla.

When the Pantepec overflows, the soft soils of the Sierra Norte break away from the mountain slopes, and this endangers its inhabitants, especially between the months of June and October, when the rains are highest in the region.

This article related to a river in Mexico is a stub.