It flows for 60 miles (96 km)[1] and reaches the sea at a substantial ria, the Exe Estuary, on the south (English Channel) coast of Devon.

[2][3] The same root separately developed into the English Axe and Esk, the Welsh Usk, though not, as some have claimed, the word whisky, this latter being from the Classical Irish/Gaelic uisgi "water" (the fuller phrase being uisgi betha; Irish: uisce beatha; Scottish Gaelic: uisge beatha; "aqua vitae" ("water of life")).

The city's first industrial area was developed at Exe Island, which was created in the 10th century by digging a series of leats into the sandy and marshy land bordering the river.

It is populated with wild brown trout, and in the lower reaches coarse fish including dace, chub, perch, roach, pike and bream and some grayling, the average size being 8–10 ounces (230–280 g).

In 2008 the Environment Agency embarked on a project to clear vegetation from the river in Exeter as well as make way for flood defence work.