The upper reaches of the Tieton River are found near the summits of the Washington's Cascade Mountains. The north fork begins a White Pass Ski Area and the south fork flows from the McCall Glacier on Old Snowy Mountain. After they join, the river is blocked by the Rimrock Dam, which creates Rimrock Lake. Downstream, it joins the Naches River.

The river is a popular whitewater run in the fall during the annual reservoir release.