In the 1990s, a microorganism outbreak on the lower river, possibly Pfiesteria piscicida, led to widespread fish kills and illness among the watermen who fish the river and Pocomoke Sound.
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From the mouth of the river, they are (or were), on the right bank: the landings at Shelltown (called for many years Steamboat Landing) and Rehobeth (both in Somerset County), Puncheon Landing, Stevens Ferry, Cottinghams Ferry, Milburn Landing (now in the Milburn Landing section of the Pocomoke River State Park), and Adams Wharf, all in Worcester County.
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