It rises south of Bishopbridge (west of Market Rasen), passes through Brigg and flows into the Humber at South Ferriby.
The river has a distincly rural character, and the landscape is agricultural.
Boats have used the river for many centuries, and it was an important route for transporting cargo from the rural communities to the industrial towns. In the 19th century, a passenger packet boat ran from Brigg to South Ferriby and conected with a steamer to Hull.
The river runs in two intertwining channels known as the "Old River Ancholme" and the "New River Ancholme". While the Old River maintains its natural course, the New River flows almost straight as it is the product of engineering work.
As early as the 13th century local landowners paid subscriptions for work to be undertaken with the aim of facilitating navigation and land drainage. The river's charter is one of the oldest in the country.
Nowadays the river is used mainly for recreation, with over 200 boats registered.