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Course
The Okanogan (American English) begins its 115 mi journey in Penticton in the southern interior of British Columbia, where it is referred to as Okanagan River (Canadian English). Okanagan Lake – 1,122 ft above sea level – form the river's headwaters. The deep lake is located in the Okanagan region of British Columbia east of the North Cascades mountain range. For its first 4 mi, the river flows southeast connecting the Okanagan and Skaha Lakes through Penticton. The Okanogan continues in the unincorporated community of Okanagan Falls and town of Oliver, although it becomes Osoyoos Lake, which is positioned 912 ft above sea level in the Okanagan and the adjacent Okanogan county of Washington in the town of Osoyoos and city of Oroville. At the mouth of Osoyoos Lake, the Okanogan, now past the Canada–United States border, continues.

The Okanogan passes through the cities of Tonasket, Omak and Okanogan, all in Okanogan County. It marks the western border of the Colville Indian Reservation, inhabited and managed by the federally recognized Confederated Tribes of the Colville Reservation. The Similkameen River joins near Oroville, while the Okanogan empties into the Columbia River from the north 781 ft above sea level, 5 mi east of Brewster, between the Wells Dam (downstream) and the Chief Joseph Dam (upstream). The reservoir behind Wells Dam, into which the Okanagan empties, is called Lake Pateros. The Columbia ultimately empties into the Pacific Ocean just west of Astoria, Oregon.

The Okanogan drains an area of about 8,200 sqmi. Its drainage basin covers six major lakes: Okanagan, Kalamalka, Wood, Shaka, Vaseux and Osoyoos, in addition to the northern Canadian communities of Armstrong, Vernon, Coldstream, Lake Country, Kelowna, West Kelowna, Peachland, Summerland and the southern American community of Pateros. The Okanagan Basin almost drains identical region as the drainage basin for Okanogan River, which is two-thirds of Vancouver Island. The Okanogan shares its name with nearby places, such as Okanogan County and Okanogan, as well as with landforms and bodies of water.

The average flow at the mouth of the river is recorded to be 643 cfs (18.2 m³/s) near the Oroville area of Okanogan County. Discharging at Malott, Washington, at a maximum of 45,600 cu ft/s (1,291 m³/s) and a minimum of 288 cu ft/s (8 m³/s), the river discharges averagely at 3,039 cu ft/s (86 m³/s).