It rises at Saco Lake in Crawford Notch in the White Mountains and flows generally SSE through Bartlett and Conway in Carroll County, New Hampshire before crossing into Oxford County, Maine. After running through six hydropower stations and entering York County, the river crosses under Interstate 95 and passes between Saco and Biddeford, where it is bridged by U.S. Route 1. It enters Saco Bay on the Atlantic with Camp Ellis in Saco on the north shore and Hills Beach in Biddeford on the south shore.
The United States government maintains two river flow gages on the Saco river. The first is at Conway, New Hampshire ( ) where the rivershed is 385 square miles (997 km˛). Flow here has ranged from 47,200 to 40 cubic feet per second. The second is at Cornish, Maine ( ) where the rivershed is 1,293 square miles. Flow here has ranged from 46,600 to 244 cubic feet per second.[1]
The Saco is thought to be one of the most popular recreational rivers in the United States, drawing an estimated 3,000 to 7,000 people per summer weekend, mostly on the stretch from Swan's Falls (a campground maintained by the Appalachian Mountain Club) to Brownfield, Maine. Multiple violent and reportedly alcohol-related incidents in 2001 led to increased police patrols and efforts by livery companies, landowners, and government agencies to improve conditions

