The Etowah River is a 164-mile-long (264 km) waterway that rises northwest of Dahlonega, Georgia, north of Atlanta. Its name is the Cherokee version of the original Muskogee word Etalwa, which means a "trail crossing". On Matthew Carey's 1795 map the river was labeled "High Town River". On later maps, such as the 1839 Cass County map (Cass being the original name for Bartow County), it was referred to as "Hightower River", a name that was used in most early Cherokee records.
The large Amicalola Creek (which flows over Amicalola Falls) is a primary tributary near the beginning of the river. The Etowah then flows west-southwest through Canton, Georgia, and soon forms Lake Allatoona. From the dam at the lake, it passes Cartersville and the Etowah Indian Mounds archaeological site. It then flows to Rome, Georgia, where it meets the Oostanaula River and forms the Coosa River at their confluence. The river is the northernmost portion of the Etowah-Coosa-Alabama-Mobile Waterway, stretching from the mountains of north Georgia to Mobile Bay in Alabama.
The Little River is the largest tributary of the Etowah, their confluence now flooded by Lake Allatoona. Allatoona Creek is another major tributary, flowing north from Cobb County and forming the other major arm of the lake.