Maximum discharge along the river is currently at the reporting a streamflow rate of cfs. This is also the highest stage along the Twisp River, with a gauge stage of ft at this location. This river is monitored from 1 different streamgauging stations along the Twisp River, the highest being situated at an altitude of ft, the .

The Twisp River flows for 42 miles through the Methow Valley in Washington state. Historically, the river was a significant source of salmon and trout for local Native American tribes, who relied on the fish for sustenance and cultural traditions. Today, the river is primarily used for recreation, with activities such as fishing, rafting, and hiking. The river's hydrology is influenced by the surrounding mountain ranges, and it experiences high flows in the spring and early summer due to snowmelt. There are several dams and reservoirs along the river, including the Twisp River Dam, which was built in 1965 to provide irrigation water for nearby agricultural land. The river is also part of the Columbia River Basin, which supplies water for irrigation and hydroelectric power to the region.