Shortly after exiting Cowichan Lake, the river drops over Skutz Falls, a small waterfall that is often visited when fish are climbing the fish ladder constructed beside the falls. Below the falls, in the summer time, are some great swimming areas. A ways downstream from that the river flows through Marie Canyon, a popular kayaking run.
The river is widely considered one of the finest trout fishing streams in British Columbia. The Cowichan River is the centre of a provincial park, the Cowichan River Provincial Park, on southern Vancouver Island. The park area is home to hundreds of animal species: small and large mammals, including the native Vancouver Island ermine, an endangered species, and more than two hundred species of birds.
The river is also the namesake of Cowichan Herald Extraordinary at the Canadian Heraldic Authority.