[1] The US and Canada border stations are located at the opposite ends of this span.

The crossing is the westernmost of the three on the St. Lawrence River and is very busy, with up to two hours of waits during the summer.

[2] The US border station of Alexandria Bay has sometimes been called "Thousand Islands", and the Canada border station of Lansdowne has sometimes been called "Gananoque", named for the nearby town where international ferry service has historically been (and continues to be) provided.

These border stations are also responsible for inspecting vessel traffic between the two countries.

The US has seasonal vessel inspection stations on Heart Island and at Cape Vincent, New York, and Canada has seasonal vessel inspection stations at Rockport, Ontario, and Gananoque, Ontario, and both Canada Border Services Agency (CBSA) and the U.S. Customs and Border Protection (CBP) will travel to selected ports and marinas to conduct inspections upon request.