Formed from several small rivers which are fed by glaciers surrounding Mount Aspiring / Tititea, it flows north along a valley flanked in the west by the Haast Range before turning northwest to reach the Tasman Sea 20 kilometres (12 mi) southwest of Haast.

Much of the river's length is within Mount Aspiring National Park.

The New Zealand Ministry for Culture and Heritage gives a translation of "water of blood" for Waiatoto.

[1] "Place name detail: Waiatoto River".

This article about a river in the West Coast Region of New Zealand is a stub.