The river rises from Mount Ōmine in the Yoshino-Kumano National Park in Tenkawa, Nara and follows a generally southward course to drain into the Pacific Ocean on the border between Shingū, Wakayama and Kihō, Mie. The river is part of the Sacred Sites and Pilgrimage Routes in the Kii Mountain Range, a UNESCO World Heritage Site which incorporates nature scenery of the Kii peninsula with numerous Buddhist temples and Shinto shrines forming a pilgrimage route.