The river flows east into the Atkinson and Gilmanton Academy Grant, where it is joined by its west branch.
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The river then enters the Dartmouth College Grant and is joined by its south branch.
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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.
The river, never larger than a brook, flows northeast into the Atkinson and Gilmanton Academy Grant, where it joins the Little Dead Diamond River.