The Fortescue River flows through Millstream Chichester National Park in the north Pilbara region of Western Australia, roughly a two-hour drive southeast of Karratha. The river supports two distinct paddling environments: an inland section within the national park, and a tidal lower reach extending to the river mouth on the coast.

Within the national park, Crossings Pool is a noted access point for canoeing, with associated camping, picnicking, and hiking facilities on site. Deep Reach Pool is another significant location along the river, though paddlers should be aware that it holds deep cultural and spiritual importance for the local Yindjibarndi people and neighbouring Indigenous communities, and should be treated with appropriate respect.

At the river mouth, a government-listed boat ramp provides access to the lower tidal section. This ramp is described as a rough, fairly steep gravel bush ramp, and the tidal range at the mouth is approximately five metres, which creates variable and potentially challenging launch and retrieval conditions. Four-wheel drive capability is advisable for accessing this ramp.

The surrounding landscape supports over 500 plant species, 120 bird species, 30 mammal species, and 150 reptile species, making the river corridor of considerable interest to wildlife-oriented paddlers. The mid-winter period between June and August brings a notable wildflower display along the riverbanks.

Paddlers planning trips to the inland section should check for road and park closures in advance, as access conditions in the Pilbara can change. The river sits within a desert environment, and the national park section represents a distinct riparian oasis within that broader arid landscape.