The Dead Diamond River is formed in the township of Atkinson and Gilmanton Academy Grant, New Hampshire by the juncture of the Middle Branch and the East Branch of the Dead Diamond.
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The Little Dead Diamond River joins from the west at Hell Gate, a set of rapids, just before the Dead Diamond enters the Dartmouth College Grant.
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The river passes through the townships of Dixville and Dix's Grant before joining the Dead Diamond River in the Dartmouth College Grant.
The river, never larger than a brook, flows northeast into the Atkinson and Gilmanton Academy Grant, where it joins the Little Dead Diamond River.