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The Okanogan River rises in southern British Columbia (where it is known as the Okanagan River), issuing out of the southern end of Okanagan Lake, which is on the north side of the city of Penticton. It flows south past Penticton, through Skaha Lake, past Okanagan Falls, through Vaseux Lake, and past Oliver to Osoyoos and Osoyoos Lake, which spans the Canada – United States border and has its outlet into the Okanogan River at Oroville, on the southern shore of the lake, in Okanogan County. At the border the river's name (and the region and also the name of the Okanagan Highland) changes spelling from Okanagan to Okanogan. Average annual flow of the river at this point is 643 cfs (18.2 m³/s).
From Oroville the Okanogan River flows south through the Okanogan County, past Okanogan and Omak. It forms the western boundary of the Colville Indian Reservation. The Okanogan River enters the Columbia River from the north, 5 miles (8 km) east of Brewster, between the Wells Dam (downstream) and the Chief Joseph Dam (upstream). The reservoir behind Wells Dam, into which the Okanagan empties, is called Lake Pateros.
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