In its upper reaches is a region of mostly flat water and lakes.

[4] The Saranac River empties into Lake Champlain at the City of Plattsburgh in Clinton County, New York.

The river flows in a northeasterly direction from the Adirondack Mountains.

[2] The Saranac River has a fairly diverse fishery, including northern pike, largemouth bass, smallmouth bass, rock bass, pumpkinseed, fallfish, brown bullhead, brown trout, and landlocked atlantic salmon.

The river is also part of the 740-mile Northern Forest Canoe Trail, which begins in Old Forge, NY and ends in Fort Kent, ME.