The Tsitsa Falls are located in its upper course, amidst a mountainous area of great beauty.

The Tsitsa River used to form part of the western border of the former Transkei.

Now the Tsitsa is a popular place for whitewater kayaking.

[3] There are only relatively small dams in the Tsitsa River basin.

The Maclear Dam on the Mooi River supplies water to Maclear town and the Ugie Dam on the Wildebeest River supplies water to Ugie town.