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Formed by the confluence of the Gara River, Salisbury Waters and Bakers Creek, the Macleay River rises east of Uralla within the Great Dividing Range. The river flows to the sea east by south, joined by twenty-six tributaries including the Apsley, Chandler, and Dyke rivers. By the time it reaches the ocean at South West Rocks it will have travelled 298 kilometres. The Macleay River is said to be the second fastest running river in the world. In its upper reaches it passes through some rugged landscapes and gorges creating spectacular waterfalls in the Cunnawarra and Oxley Wild Rivers National Parks.
However it is its lower reaches that are most known and which have generated townships and a range of economic activities. The river flows adjacent to the city of Kempsey and has been ever present with a number of major flood episodes affecting Kempsey and downstream areas. This area and its problems have been ameliorated by the construction of variety of works including the opening in 2014 of the Macleay River Bridge, the longest road bridge in Australia. It is this downstream flood plain area that has seen the greatest links over time between the river and supporting townships. Visiting places today such as Frederickton, Gladstone, Smithtown and Jerseyville provides an insight into these strong connections to the river, past and present.
The township at the mouth of the River today, South West Rocks has its own distinct history. When Europeans arrived in the area around the 1820s the river mouth was just south of Grassy Head, and almost a mile wide with a sand spit in the middle. The small town of Stuarts Point was established on the river just inside to serve arriving ships. The area from Grassy Head to what is now South West Rocks was a wide delta with various channels connected to the river. In 1893 a flood enlarged an opening near South West Rocks and the Government of the day decided to improve that opportunity, called New Entrance. Work on the new entrance commenced in April 1896, improving the channel and adding training walls. A new pilot station was built in 1902, establishing the town of South West Rocks. Work was completed in 1906. Today the old mouth has silted up. South West Rocks and the nearby Trial Bay Goal are today a popular tourism destination with a focus on coastal and heritage tourism experiences.