The river, which begins in the Garibaldi Ranges of the Coast Mountains, is in two sections above and below Pitt Lake and flows on a generally southernly course.

The first mention of the name, as "Pitts River", occurs in the 1827 journal kept by James McMillan of the Hudson's Bay Company.

The farmland is on the east bank in Pitt Meadows; the poorer soil quality and scrubland on the west shore has encouraged largescale suburbanization in Port Coquitlam.

On the west shore in the upper stretches of the lower Pitt is Minnekhada Regional Park, residence of former British Columbia lieutenant-governor Clarence Wallace.

The upper Pitt's basin is short but fed by a number of ice fields, glaciers, and mountain streams, such as Garibaldi Névé and Mamquam Icefield.