The river rises on the eastern flanks of the Southern Alps, eight kilometres southwest of Arthur's Pass. For much of its upper reaches, the river is braided, with wide shingle beds. As the river approaches the Canterbury Plains, it passes through a belt of mountains, and is forced into a narrow canyon (the Waimakariri Gorge), before reverting to its braided form for its passage across the plains. It finally enters the Pacific north of Christchurch, near the town of Kaiapoi.
Geological evidence indicates that the river mouth has been very mobile, at times flowing through the current location of Christchurch and even flowing into Lake Ellesmere south of Banks Peninsula for a time.
The river is known colloquially in Canterbury as "The Waimak".
Its Maori name is Otautahi, from the Maori chief Tautahi who had a settlement on the banks of the Avon River.
It lies at the southern end of Pegasus Bay, in the middle of the east coast of the South Island, between Banks Peninsula and the Canterbury Plains.
It is bounded, to the east by the Pacific Ocean coast and the estuary of the Avon and Heathcote rivers, to the south and south-east by the volcanic slopes of the Port Hills and in the north by the Waimakariririver.