The Sand Hill River flows generally west from its source, Sand Hill Lake, near the town of Fosston in Polk County, dipping south through Mahnomen County and Norman County before returning to Polk County and passing the towns of Rindal, Fertile, and Climax.
The Sand Hill River flows predominantly west from its origin at Sand Hill Lake near Fosston in Polk County, then turns south through Mahnomen and Norman Counties before re-entering Polk County and continuing past Rindal, Fertile, and Climax.