[3] Collectively, all three branches of the Pawtuxet played an important role in the development of the textile industry in New England, which utilized the river system for hydromechanical and later early hydroelectric power during the 19th century.

[5] However, since the enactment of the federal Clean Water Act in 1972, and subsequent federal and state enforcement, it has become unfeasible to continue legal industrial process wastewater discharge into the river and all known private direct industrial process wastewater discharges have been eliminated throughout the Pawtuxet system.

According to the "State of Rhode Island 2018-2020 Impaired Waters Report-February 2021" the Lower Pawtuxet is considered impaired for phosphorus, mercury, enterococcus bacteria and invasive plants and is still yet to meet its targeted intended public use of fully supporting fish and wildlife, as well as primary (swimming) and secondary (boating) recreational contact.

This project created access of over 7.5 miles of freshwater spawning habitat for diadromous species from the Atlantic Ocean.

Rhode Island's capital city of Providence has long used the Pawtuxet River System for a centralized water supply.

From October 13–15, the National Weather Service reported 7 to 9 inches (230 mm) of rain in Rhode Island and the Pawtuxet River at Cranston and Warwick recorded its second worst flood, cresting at a stage of 13.68 feet (4.17 m).

[8] On March 29 and 30, 2010, an additional 6-10 inches of rainfall across Southern New England in addition to the 3+ inches that fell on the 23rd, bringing the total rainfall for the month of March to over 16" and causing the Pawtuxet River to exceed the previous flood level occurring only two weeks prior.

The flooding also forced many schools to be closed for an extended period of time, due to road closures and washouts.