The Waihou River flows through the Waikato region of New Zealand's North Island, offering a paddling experience that takes in a mix of pastoral farmland, meandering lowland channels, and tidal reaches before emptying into the Firth of Thames near the town of Thames. The river is suitable for canoeing, kayaking, and paddleboarding.

For those paddling the upper reaches, a recommended put-in is at the Opal Hot Springs area or at the State Highway 24 crossing beside the river. Paddlers are advised not to start south of this point. A popular longer route runs from the Putaruru area downstream toward Paeroa, with the river passing through Te Aroha along the way. In Te Aroha, a boat ramp is located just downstream of the main road bridge off Honi Street and Lawrence Avenue. The lower river has numerous access points, including boat ramps at Thames Wharf at the southern end of the township, Kopu Boat Ramp off Quay Street, and a ramp off Hubbard Road near the main Waihou River bridge opposite the Maritime Park Museum on SH2 before Paeroa. Additional access at Turua is available off Piako Road.

The river has many twists and turns in its lower reaches, which can make navigation and landing at specific points more challenging than expected. Paddlers should be attentive when approaching take-out ramps, as the river's meandering character can cause misjudgment of distances and landing positions.

The upper Waihou is notable for its spring-fed clarity, with the Te Waihou Walkway and Blue Spring accessible from Whites Road and Leslie Road. In this section the river meanders across open farmland with short, deep pools and long cobblestone runs. Large springs feed into the river approximately four kilometres above Whites Road. The upper river is well known for its exceptionally clear water and has hosted the World Fly Fishing Championships, reflecting the quality of the aquatic environment. The lower river transitions to a broader, tidal character as it approaches the Firth of Thames, with boat ramps spaced along its length providing options for multi-day or sectional trips.