The river originates in the lake Orkelsjøen in the municipality of Oppdal in the Dovrefjell mountains. The river runs through the municipalities of Oppdal, Tynset, Rennebu, and Orkland. The municipalities are all in Trøndelag county, except for Tynset, which is in Innlandet county. Major towns and villages along the river include: Orkanger, Fannrem, Vormstad, Svorkmo, Storås, Meldal, Å (in Orkland); and Voll and Berkåk (in Rennebu).