The North Esk River arises from the Ben Lomond range in northern Tasmania and flows through forested valleys, open farmland, and the suburbs of Launceston before joining the Tamar River. The river winds through a combination of forest and agricultural land featuring considerable willow growth along the banks, particularly in the lower sections. It is one of the more popular paddling destinations in the Launceston area, partly because it can come into flood at different times than the nearby South Esk, giving local paddlers more frequent opportunities on the water.

There are three main paddling trips on the North Esk, ranging from 6 to 17 kilometres, and a longer 22-kilometre option beginning from the St. Patrick's River at Nunamara. The upper reaches near Blessington are grade 1 and have been cleared of willows, but can only be paddled in flood conditions, offering 16 kilometres of continuous grade 3 to 4 whitewater. The middle section from White Hills to Corra Linn is the most reliably paddled stretch, typically runnable between June and October, with an average gradient of 8 m/km and a peak gradient of 50 m/km around "the Big Bend." The ideal gauge reading for this section is around 4.5 metres, measured from a track on the southern side of the Corra Linn Bridge. The river has been paddled at heights up to 6.5 metres in extreme flood, but this constitutes very big water.

The lower North Esk, a 6-kilometre trip, is described as the most popular grade 3-plus river trip in Tasmania. It begins with grade 1 to 2 rapids for the first 2 kilometres before entering a gorge with frequent grade 3 rapids bearing names such as "Zig-zag," "Bastard," "Horseshoe Falls," and "Diagonal Stopper." These lead to the 5-metre "First and Second Drops," which are generally tackled only by expert paddlers. This section should only be attempted by competent paddlers, preferably with local guides. Below Corra Linn, the river is grade 1 but heavily overgrown with willows and prone to log jams, particularly on two right-hand bends where flow can push through willows at higher levels.

The river rises and falls quickly following rain, a characteristic attributed in part to extensive logging in the upper catchment. Paddlers should monitor water levels carefully and be aware that conditions can change rapidly.