Pilottown is built on piers in swampy ground on the East Bank of the lower Mississippi River, about 85 miles (137 km) downriver from New Orleans (65 miles or 105 km by air) and about 10 miles (16 km) south of Venice, Louisiana. Pilottown is located a few miles above Head of Passes, the point considered to be the mouth of the Mississippi River. Below there the River splits into multiple branches. This is part of the active delta front that has, over time, built up the larger Mississippi River Delta.