The Kiamichi River rises in southeastern Oklahoma in the Kiamichi Mountains in
Le Flore County. It flows in a west-southwesterly direction until it reaches the
Sardis Lake area where it turns to the southwest. It then bends south and east emptying into
Hugo Lake. It exits the lake in a southeasterly manner and finally reaches its end at the
Red River where it contributes to
Raymond Gary State Park.
In addition to Le Flore county, the river passes through Pushmataha County and Choctaw County.