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 primarily west from its source at Sand Hill Lake near Fosston in Polk County, then turns south through Mahnomen and Norman Counties before re-entering Polk County and continuing on past the towns of Rindal, Fertile, and Climax.