The Esk River is located in the Esk Valley along the Napier–Taupo highway (SH5), approximately 15 minutes' drive from Napier in Hawke's Bay on the North Island. The river has been assessed for whitewater kayaking and the documented paddling reach runs from the end of Ellis Wallace Road downstream to the SH2 bridge, a flatwater section that has been used for school paddling programmes, including through operators such as Kiwi Adventure. Its low technical rating places it firmly at the beginner or introductory end of the spectrum, with recorded flows in the range of 100–500 cumecs.

Access to the lower river is available at the end of Ellis Wallace Road, where a ford crosses the river and marginal strip runs up both banks providing access to over 10 kilometres of river. A parking bay is also available just after the railway crossing on Ellis Wallace Road. The river mouth can be reached via Le Quesne Road off SH2, with approximately a 400-metre walk along the beach from the road end. Eskdale Park, accessible via Shaw Road off SH5, provides another entry point with a vehicle track leading to the river's edge.

The river flows through farmland in the Esk Valley and drains to the coast near Napier. It should be noted that the river and surrounding area were significantly impacted by Cyclone Gabrielle, and paddlers planning a visit should verify current conditions and access before launching, as the event may have altered the river channel, access tracks, and surrounding infrastructure.