The Touw River flows through Wilderness National Park on South Africa's Garden Route, offering calm, flat water suitable for paddlers of all experience levels, including beginners and families. The river winds through indigenous forest and reed beds, making it a popular year-round paddling destination.

The primary access point is the Fairy Knowe Hotel, where single and double canoes can be hired. A SANParks conservation fee is required and can be paid at the same location. Canoes come equipped with large waterproof buckets suitable for storing cameras, picnics, and daypacks. Paddlers can also begin a journey from the Ebb & Flow Rest Camp, paddling down the Touw River toward the Wilderness Lagoon.

Three main routes are available from the Fairy Knowe Hotel. The most popular leads to the Touw River Waterfall, involving approximately 40 minutes of paddling covering roughly 3 kilometres through indigenous forest, followed by a 40-minute, 2.5-kilometre walk along a boardwalk to the waterfall. The waterfall area is suitable for a picnic and swimming. The second route heads to Island Lake via the Serpentine River, a 1.5 to 2 hour paddle covering approximately 3.5 kilometres one way through meandering reed beds with abundant birdlife; the full round trip takes 4 to 5 hours. A picnic site is located on the left upon reaching Island Lake. The third option is a 30 to 40 minute paddle to the River Mouth, where the river widens and the banks become more developed. All routes are returned via the same way paddled in.

The river passes through lush vegetation and reed beds that support a wide variety of bird species. The birdwatching is noted as particularly rewarding on the Island Lake route. The Touw River connects to the broader network of waterways in the Wilderness area, including the Wilderness Lagoon, and the surrounding landscape is characterised by dense indigenous forest typical of the Garden Route.

Because the activity takes place within Wilderness National Park, paddlers are required to pay the SANParks conservation fee. The activity is available throughout the year.