The river's North Fork rises in northern Tillamook County and flows south.

Further downstream, the Wilson River receives the North Fork near Lees Camp.

Oregon Route 6, also known as the Wilson River Highway, runs parallel to the river and links the Tualatin Valley and the Portland metropolitan area with the Oregon Coast.

This is from a drainage area of 161 square miles (417 km2), about 83 percent of the total Wilson River watershed.

[5] The Wilson River was part of the Willamette Valley flood of 1996 when it rose to 19.51 inches on February 8, damaging roads and farms and houses in Tillamook.