The course of the Sukhona lies in Ust-Kubinsky, Sokolsky, Mezhdurechensky, Totemsky, Tarnogsky, Nyuksensky, and Velikoustyugsky Districts of Vologda Oblast in Russia.

The Sukhona joins the Yug near the town of Veliky Ustyug, forming the Northern Dvina, one of the biggest rivers of European Russia.

The towns of Sokol, Totma, and Veliky Ustyug, as well as the villages and district centers Shuyskoye and Nyuksenitsa, are located on the banks of the Sukhona.

The canal is still in operation, serving cargo traffic and occasional cruise ships, which then proceed to Lake Kubenskoye.

The area was populated by Finnic peoples and then colonized by the Novgorod Republic, with the exception was Veliky Ustyug, which was part of Vladimir-Suzdal Principality.

The river quickly lost its role as the leading trading route, which was accelerated by the construction of the railway between Vologda and Arkhangelsk between 1894 and 1897.