The river has its source in the northern region of the Eastern Cape, in the area of Matatiele and Mount Fletcher near the Lesotho border.

[4] In 1635 Portuguese ship 'Nossa Senhora de Belem' ran aground at the mouth of the Mzimvubu River.

[6] Formerly the river mouth was used as a harbor, but this activity was abandoned in the 1940s when the estuary became too shallow for large vessels owing to siltation and the fact that the entrance is sometimes obstructed by sand.

Presently the estuary is river is navigable only for small craft for about 10 km upriver.

[9] Bull sharks frequent the waters and are known to breed in the river and are linked to a spate of attacks on nearby beaches.