The river begins at a diversion dam at McKay's Point, about a mile west of Lemon Cove.

Tulare lake was the terminal sink of an endorheic basin in southern San Joaquin Valley which was also watered by the Kern, Tule, and by some distributaries of the Kings River.

This water in time of flood finds its way into the Tulare Lake Basin through Elbow Creek.

[6] In 1889, the Tulare Irrigation District was organized, and that body constructed a series of canals which diverted water from the river.

[7] In 1906, the St. John's River levee broke, and water poured into Visalia from the north, which helped cause the floods of 1906.