During the later Middle Ages, it was also known as the Salamvrias or Salavrias (Σαλα[μ]βριάς).

It flows from the Pindus mountains through the Thessalian plain and empties into the Aegean Sea, northeast of the Vale of Tempe, near Stomio.

It creates a large delta, well known for its beauty and for many animal species, protected by international environmental treaties.

[2] Its source is near the village Malakasi, on the eastern slope of the Pindus main range, east of Metsovo.

The Pineios flows along the following places, from the source downstream: Malakasi, Kalampaka, Megarchi, Megala Kalyvia, Farkadona, Larissa, Evangelismos, Omolio.