The Northwest Miramichi River is a tributary within the broader Miramichi River watershed in New Brunswick, flowing through wilderness terrain before joining the main river system near Wayerton. All tributaries in this watershed ultimately converge at the City of Miramichi, where the main branches meet at the Tickle, a narrow passage separating Wilsons Point from Beaubears Island.

A common access point is the bridge on Route 430, where paddlers can put in for a long wilderness paddle that loops out and returns to Wayerton. From the Route 430 bridge, approximately 10 kilometres of paddling on the Northwest Miramichi brings paddlers to a river bank on the left side. The river also serves as the starting point for more ambitious multi-day expeditions, including a historic portage route via the Portage River toward the Nepisiguit watershed, though this route involves challenging navigation through dense alder thickets and requires proficiency in poling, particularly in the upper sections near the mouth of the Portage River.

The character of the river is predominantly wilderness-oriented, with limited infrastructure and few established campsites along the route. Paddlers undertaking extended trips should be prepared to improvise campsite locations. The portage connection to the Nepisiguit system is considered a very remote undertaking, with fewer than ten paddlers having completed it in recent decades.

For those seeking a more straightforward outing, the paddle from Route 430 out through the wilderness and back to Wayerton offers an extended day trip or overnight experience in a largely undeveloped setting. The broader Miramichi watershed, including the Northwest branch, is best paddled during the May long weekend when water levels are typically adequate, as water tends to run low during summer months.