The region drained by the Nambucca River consists of the coastal plain to the Great Dividing Range. Taylors Arm and Nambucca Creek meet just before Macksville. The river estuary is located at Nambucca Heads. Other towns in the water catchment include Bowraville. The small town of Taylors Arm is famous for inspiring the Slim Dusty song The Pub with No Beer.
The Nambucca River area has a fine subtropical climate, high rainfall and fertile volcanic soils. It was originally covered by rainforest, much of which has been cleared. Some remains in several national parks and reserves. The lowlands along the river are used for farming.