The Similkameen River flows through the Similkameen Valley of British Columbia, closely following Highway 3 from Princeton through Hedley, Keremeos, and Cawston toward the BC-Washington border. The river sustains agricultural farmlands and grasslands along its corridor, passing orchards, vineyards, ranches, and rocky bluffs. The surrounding landscape features ponderosa pine, rugged rocky outcroppings, and open grasslands typical of the BC interior.

The river offers a range of paddling experiences, from relaxed floating to Class II rapids. The stretch near Bromley Rock Provincial Park, located 21 km east of Princeton, includes boulders that create Class II rapids just below the rock bluff. For those seeking a multi-day trip, the run from Princeton to near the BC-Washington border covers approximately 100 km and is suitable as a packraft or canoe journey of three to four days. The river is rated intermediate to advanced (Class II-III) in organized trip contexts, though much of the lower valley is accessible to beginners and casual floaters.

Common access points include the Bridge of Dreams in Princeton, Bromley Rock Provincial Park, the Keremeos Red Bridge, Kobau Park in Cawston, and the Chopaka Wooden Bridge. Drifting times between key points are roughly eight hours from Bromley Rock to the Red Bridge, two hours from the Red Bridge to Keremeos Pine Park, and three and a half hours from the Red Bridge to Kobau Park in Cawston. There is also a put-in just before Similkameen Falls, accessed by lowering boats down a steep bank on the river side of the highway.

Summer is the primary paddling season, when the river is popular for tubing, kayaking, and canoeing. Water flow fluctuates with the season, and undercurrents are a noted hazard. Paddlers are advised to check with local visitor centres for current river access conditions, as flooding events can affect access points. The river is also noted for wildlife, including birds of prey. Bromley Rock Provincial Park provides a fully facilitated campground, making it a practical base for multi-day trips. Camping on the riverbank is also possible along the more remote stretches.