Major settlements along the banks of the river include Te Karaka, Ormond, and Pātūtahi.

[1] The river has formed the fertile and highly productive Poverty Bay flats on the edge of Gisborne.

[3] Stopbanks are to be raised by 2031,[4] as soil erosion, especially from the Waingaromia and Mangatu catchments, has built up the river bed, the annual flow of sediment being 15 million tonnes.

[2] In the lower river, water quality is poor for E. coli, clarity, turbidity, ammoniacal nitrogen and total phosphorus.

[5] The sediment, building up at the rate of several centimetres a year, even many kilometres into Poverty Bay, shows that removal of trees such as rimu, matai and kaihikatea and then converting fern covered areas to farmland by the early 20th century, increased sediment flows by 2 to 3 times the former rate.