It is fed by groundwater held in the chalk aquifer of the Chiltern Hills and rises from three springs which surface as Vale brook, from Bury Pond, and alongside the Missenden Road near Pednor just to the north of Chesham.

The river flows below parkland landscaped by Capability Brown at Latimer House and the site of a 1st Century Roman villa close to the village of Latimer; to the north of Chenies; through unimproved water meadows at Frogmore and the watercress beds at Sarratt Bottom to the west of Sarratt.

The Chess flows under the M25 motorway at Solesbridge Lane, before passing through the private housing estate of Loudwater, whose name was historically associated with the river at this point.

Local speculation during the river drought of 2005 was that over-extraction for bottling, by Nestlé's Powwow Water was a significant contributing factor.

In 2005 Councillor Justine Fulford campaigned to prevent the extension of the licence on the grounds that it was damaging to the local environment.

At Sarratt strip lynchets can be seen in terraces along the hillside made by the action of ploughing along the slope and thought to have been the site of medieval vineyards.

River modifications such as dredging and widening slow the current, allow silt to accumulate and smother the gravel riverbed.

Water meadows have been replaced by arable fields and building developments, altering drainage patterns and causing pollution.

This population crash was caused mainly by the North American mink, a species introduced to the British Isles originally for the fur trade.

Originally imported by the aquaculture industry, the signal crayfish was seen as a way for trout farms to diversify and exploit new markets.

[7] Historically, the clear chalk stream water of the River Chess, together with the fertile land, was ideal for growing watercress, and this industry which flourished in both Chesham and Rickmansworth in the Victorian era supplied London, being transported on the newly constructed Metropolitan Railway.