At its southern end, the Rouge River is the boundary between Toronto and southwestern Pickering in the Regional Municipality of Durham.

After the eradication of both the Petun and the Wyandot (Huron), Senecas from New York attempted to establish/expand their fur trade activities by establishing a village named Gandechiagaiagon (recorded variously as "Gandatsekiagon", "Ganatsekwyagon", "Gandatchekiagon", or "Katabokokonk"), meaning "sand-cut" at the mouth of Rouge River.

[3] According to a 1796 list by English surveyor Augustus Jones, the Mississauga name for the river was Gichi-ziibiins (recorded as "Che-sippi"), meaning "large creek.

A plan to build condominiums and townhouses across from the Touge in Pickering in 2000 was shutdown due to threat to native species.

As for the York Region sections, the southern watershed runs through residential areas (south of Major Mackenzie Drive and west of Markham Road) and is lined with a few small municipal parks.

While many exclusive homes and conclaves border this area on the southern tip, it is currently surrounded largely by agricultural land.

Unlike other rivers in the Toronto area, it is allowed to fill its entire flood plain on a regular basis rather than being forced through an artificial channel.

[8] There are a number of local parks around of the Rouge watershed managed by the municipalities of Markham, Pickering, Richmond Hill, and Toronto.