The Tambo River starts on the southern slopes of the Great Dividing Range. Initially, there are two branches of the river – one beginning in the Bowen Mountains and the other (called the South Branch) on the slopes of Mt. Bindi.
The river flows in a southerly direction through Ensay, Tambo Crossing, Bruthen and Swan Reach. Below Bruthen, the river enters the coastal plain eventually flowing into Lake King.