The Sixes River rises in northern Curry County's Coast Range Mountains and flows almost due west, crossing Hwy 101 at the unincorporated community of Sixes. It empties into the Pacific Ocean at Cape Blanco State Park.
The river is the northernmost of those from which America’s Wild Rivers Coast gets its name. The others, going south, are the Elk, Rogue, Pistol, Chetco, and Winchuck in Curry County, and the Smith and Klamath in California's Del Norte County.