The Metishto River is a tributary of the Grass River, which is, in turn a tributary of the Nelson River, that ultimately flows into Hudson Bay.[1] Its headwaters lie "a short distance from the northwest arm of Moose Lake".
The river runs parallel to railway from The Pas to Churchill, for much of its length.[2]
In October 2018 a train operated by the Arctic Gateway Group derailed while crossing the river, releasing "liquid petroleum".[3][4][5][6][7][8]