The headwaters of Salem Creek are on the southern side of Lee Mountain. In its middle reaches, it passes through the escarpment of Summer Hill. North of that hill, the creek's valley is deeply incised. Just upstream of Summer Hill, it passes through a rocky gorge with potholes and plunge pools. The gorge is relatively deep. Additionally, the creek descends through Sybert Hollow in its last to reach the elevation of the Susquehanna River.