The hydrographic slopes adjacent to the Mistatikamekw River are:

• north side: Oskélanéo River, Benjamin Lake, Bureau Lake (Gouin Reservoir), Nemio River, Saraana Bay;
• east side: Benjamin Lake, Dugré Lake, De La Galette River (Gouin Reservoir);
• south side: Parker Lake, Bazin River, Douville River, Gosselin River;
• west side: Oskélanéo Lake, Oskélanéo River, Tessier Lake (Gouin Reservoir), Flapjack River.

The Mistatikamekw River originates at the mouth of an unidentified lake (length: 1.3 kilometres (0.81 mi), altitude: 454 metres (1,490 ft)), located north-west of Lac Dugré. The mouth of this head lake is located at:

• 19.3 kilometres (12.0 mi) east of the mouth of the Mistatikamekw River (confluence with the Oskélanéo River);
• 21.9 kilometres (13.6 mi) south-east of the mouth of Oskélanéo Lake (confluence with Bureau Lake (Gouin Reservoir);
• 54.6 kilometres (33.9 mi) south-east of the village center of Obedjiwan, Quebec (located on a peninsula on the north shore of Gouin Reservoir);
• 25.5 kilometres (15.8 mi) north-east of the village center of Oskélanéo;
• 60.7 kilometres (37.7 mi) southwest of Gouin Dam erected at the mouth of the Gouin Reservoir (confluence with the Saint-Maurice River).[2]

From the mouth of the head lake, the course of the Mistatikamekw River flows over 35.5 kilometres (22.1 mi) according to the following segments:

• 3.1 kilometres (1.9 mi) southwesterly to the limit of Montpetit township;
• 13.5 kilometres (8.4 mi) southwesterly in Montpetit Township to an unidentified stream (from the South), the closest point to the Canadian National Railway;
• 15.5 kilometres (9.6 mi) northwesterly to the easterly limit of the Township of Faucher;
• 1.5 kilometres (0.93 mi) northwesterly in the Township of Faucher;
• 1.9 kilometres (1.2 mi) northwesterly in Achintre township, crossing Lake Cantons (elevation: 405 metres (1,329 ft)) to the mouth of the river.[3]

The mouth of the Mistatikamekw River is located at:

• 11.4 kilometres (7.1 mi) north of the village of Oskélanéo which is located along the Canadian National Railway, on the west shore of Oskélanéo Lake;
• 6.9 kilometres (4.3 mi) south-east of the mouth of the Oskélanéo River;
• 41.2 kilometres (25.6 mi) south of the mouth of the Bureau Lake (Gouin Reservoir);
• 52.3 kilometres (32.5 mi) south of the village center of Obedjiwan, Quebec which is located on a peninsula on the north shore of the Gouin Reservoir;
• 79.6 kilometres (49.5 mi) south-west of Gouin Dam;
• 105 kilometres (65 mi) west of the village center of Wemotaci, Quebec (north shore of the Saint-Maurice River);
• 193 kilometres (120 mi) north-west of downtown La Tuque.[4]

The mouth of the Mistatikamekw River merges with the Oskélanéo River. From there, the current runs on 145.5 kilometres (90.4 mi) until Gouin Dam, according to the following segments:

• 8.9 kilometres (5.5 mi) north to the South Bay of Bureau Lake (Gouin Reservoir);
• 43.8 kilometres (27.2 mi) north, to the mouth of Bureau Lake (Gouin Reservoir);
• 92.8 kilometres (57.7 mi) towards the North-East, crossing the Marmette Lake, then towards the South-East crossing in particular the Brochu Lake and the Kikendatch Bay until Gouin Dam.

From this dam, the current flows along the Saint-Maurice River to Trois-Rivières.

• Saint-Maurice River
• Gouin Reservoir, a body of water
• Kikendatch Bay, a body of water
• Brochu Lake, a body of water
• Nevers Lake, a body of water
• McSweeney Lake, a body of water
• Marmette Lake, a body of water
• Bureau Lake (Gouin Reservoir), a body of water
• Oskélanéo River, a watercourse
• La Tuque, a city
• List of rivers of Quebec