The origins of its name lie with the Franciscan convent of San Bernardino which was established in 1483 near the mouth of the river, between Intra and Pallanza.

The San Bernardino passes through the communes of San Bernardino Verbano (which takes its name from the river), Cossogno and finally Verbania, where it separates the population centres of Pallanza and Intra and falls into Lake Maggiore.

In 1892 Carlo Sutermeister, an industrialist of Swiss origins, constructed the first Italian hydroelectric power station capable of distributing electrical power; it supplied the inhabitants of Intra, Pallanza and other places in the area as well as the factories nearby.

Kayaking can be enjoyed in certain tracts of this Alpine torrent and, despite the chilly water, swimming is a popular pastime, especially at the locality Santino.

Fishing is allowed, although only for brown trout (Salmo trutta), and only outside the protected reserves which form part of the national park.