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The River Derwent rises at Styhead Tarn underneath Scafell Pike and flows in a northerly direction through the valley of Borrowdale, before continuing through Derwentwater (giving the lake its name). The river then continues into Bassenthwaite Lake, being joined by the waters of the River Greta just outside Keswick.

Beyond Bassenthwaite Lake the river flows westwards through the Isel Valley, before leaving the Lake District National Park just before reaching Cockermouth where it is met by another tributary, the River Cocker. The river flows into the Irish Sea at Workington.

The name Derwent is derived from a Celtic word for "oak trees".