The Haw rises high in Forsyth County, just north of Kernersville near the Guilford line, and flows northeast. It crosses the corner of Rockingham County, passes through Haw River State Park above Greensboro, then bends southeast through Alamance County - past Ossipee, north of Burlington, through the namesake town of Haw River - and is joined by Great Alamance Creek at Swepsonville. Saxapahaw is downstream from there. South of Saxapahaw the river forms a watery border between Orange and Chatham counties before dropping into Jordan Lake, the reservoir created by damming the Haw and New Hope Creek. Below the dam, four more miles and the Haw becomes the Cape Fear.

The Piedmont gives water enough drop to turn a wheel, and from the 1850s onward the Haw turned plenty of them. The first dam went in at Saxapahaw. Glencoe, Granite Mills, Indian Valley, Altamahaw, Swepsonville, Puryear, Bynum, B. Everett Jordan - the river is studded with dams, some still standing, some breached, one (Granite Mills) removed in 2016. Alamance Plaids, the bright cotton check that became a national fashion in the 1800s, were developed near Glencoe. The cloth from these mills helped Alamance County rebuild after the Civil War. The mills also defined the towns around them - mill villages of small houses, company stores, churches built within walking distance of the spinning rooms.

Industry that built the river towns also nearly killed the river. Twentieth-century textile dyes and finishing chemicals went into the Haw because the mills were on the bank, and for decades the water ran in colors no fish should swim through. The decline of the mills reduced the load, but suburban nutrient runoff and sediment kept the river under pressure. Cleanup has been a slow argument among environmental groups, local governments, and economic interests. The Jordan Lake Rules, recently revised, tightened the regulatory limits. Most stretches now test clean enough for recreation and water supply. The combined Durham wastewater treatment plant keeps Jordan Lake itself within limits except in occasional shallow upper-pool conditions, when normal flow dilutes the excess back down. Ten percent of North Carolina's population lives in the Haw River watershed.

The Haw River Trail, formally undertaken by local governments and private groups in 2006, is the modern restoration in physical form. A combined land trail and paddle trail will eventually connect Haw River State Park to Jordan Lake State Recreation Area, with the land portion stitched into the broader North Carolina Mountains-to-Sea Trail. There is also a wine trail - the Haw River Valley has turned into a respected grape-growing region, with wineries clustered along the river in Guilford and Alamance Counties. Towns that once smelled like dye now smell of fermenting Cabernet Franc. Indian Valley, Town and Country, Swepsonville River Park, Great Bend at Glencoe - the river has more public parks along it now than at any point in the last century.

Blue herons stalk the shallows. Beavers cut willows along the banks and rebuild their dams every spring. White-tail deer ford the river at dusk; river otters fish the deeper pools; bluegill and bream rise to dry flies in summer. None of this was guaranteed forty years ago. The Haw River Assembly, founded in 1982, has spent four decades arguing with regulators, mill owners, and developers over what the river is owed. The water that comes out of Jordan Lake's tap into the kitchens of Cary and Apex starts as Haw River runoff. The Sissipahaw who named the river would still recognize most of its bends. They would not recognize the towns. But the foothills still step down into the floodplain the way their language described them - one step at a time.