Otter Brook begins at Chandler Meadow, in the town of Stoddard, New Hampshire. It flows southwest through the towns of Nelson, Sullivan, and Roxbury, eventually entering the city of Keene, where it joins Minnewawa Brook to form The Branch.
The brook passes through Ellis Reservoir (a small lake in Sullivan) and Otter Brook Lake, a flood controlreservoir built on the boundary between Keene and Roxbury. The dam which created Otter Brook lake was completed in 1958.[2] From the village of East Sullivan to Otter Brook Lake, the brook is followed by New Hampshire Route 9.