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The Gamtoos river system is formed by the Groot, the Kouga and the Baviaanskloof Rivers. The latter is a tributary of the Kouga.
Although the rainfall in the catchment area is low, it supports a commercial irrigated agriculture in the lower catchment in which oranges, tobacco, citrus fruit and vegetables are grown. There is an estuary where the Gamtoos river enters the Indian Ocean. It is located between Jeffreys Bay and Port Elizabeth and the Gamtoos River Mouth Nature Reserve is in the area. The towns of Hankey, the oldest town situated in the Gamtoos river valley, and Patensie are situated in the lower catchment. Further inland are the towns of Steytlerville, Joubertina, Uniondale, Willowmore and Murraysburg.
Tributaries include the Loerie River, Klein River, Hol River, besides the Groot and the Kouga that form the Gamtoos.
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