From its source at an elevation of 2,005 metres (6,578 ft) in Swiss territory near the Simplon Pass it flows through the hamlet Egga to the village of Simplon. From here it follows a south-easterly course through the Gondo gorge to the hamlet of Gondo in the municipality of Zwischbergen. Turning to the east it enters Italy and passes the villages of Paglino, Iselle di Trasquera, Bertonio and Varzo; turning south it passes Ricegno, Mognata, Campeglia and Crevoladossola where it enters the Toce.