It joins the Río Bravo del Norte (known in the United States as the Rio Grande) at the town of Ojinaga, Chihuahua.

The Conchos rises in the Sierra Madre Occidental in the municipality of Bocoyna, Chihuahua, where it heads east and receives several tributaries along the way.

It then heads east again, forming Colina Lake and then passes through Camargo, Chihuahua, the main agricultural center in the region, where it receives the Florido as a tributary.

The World Wide Fund for Nature (WWF) has included the Rio Conchos in its Global 200 Freshwater Ecoregions assessment.

However, conditions are being damaged by industrial pollution, sewage, agricultural wastes, flow regulation, exotic species, and overgrazing.