It is a tributary of the Great Kei River.

It originates about 10 km to the north west of the town Elliot and flows southward to meet the right-hand bank of the Great Kei River.

Towns lying on the banks of the Tsomo River include: Tsomo, Cala and Ncora The first chief to settle in Tsomo was Chief Jantjie ka Gcingca.

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