The name of the stream may be of Anglo-Saxon origin, although it was not written down before the 14th century in the Middle English forms Smetheslall and Smethestalle, meaning ″Place of the Smiths″.^[2]  Some local people maintain that the lower part of the stream, approximately from Wombourne, is properly called the River Smestow, while the upper section is the Smestow Brook. Certainly the lower Smestow is much more impressive since dredging and course alterations in the 1990s. In practice, however, both forms are used for the whole length of the stream, with Smestow Brook predominating. Similarly, the term Smestow Valley is sometimes reserved for the narrow section from Aldersley to Wightwick, although it can be used for the entire catchment, including the much wider plain south of Trescott. The Smestow itself created neither of these features: it simply flows through a landscape opened up by glaciation in the last Ice Age.
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Gorsebrook Mill was fed by the Smestow Brook which rises in the Springfields area. It can still be heard rushing through its culvert across the old Gas Works site. St. Peter's Parish Register records the baptism, on 27th August 1613, of Michale, son of Thomas Bennet "of Gosbrook Mill". There is a detailed estimate for the reconstruction of the mill, dated 1739, in the Shaw-Hellier papers, and it apparently continued in use long after Gorsebrook House was built in the eighteenth century. At the time of the 1841 census its occupier, William Copeland, was using it to grind cement, and in 1861 Michael Healy is described as a charcoal grinder. One of its wheels was still at Gorsebrook House in the 1930s.

The Smestow Brook has its source in the Springfield area, in which many of the street names attest to the plentiful supplies of water originally found there. The natural springs were contained and culverted as building began here in the 1870s, with large quantities diverted to the Springfield Brewery.  Today there is no sign of the Smestow for several hundred metres from its putative source in Springfield. It emerges further north, in the Park Village area, at the edge of Fowler's Park.  The Smestow flows northwards through the park, supplying water for a pool, then turns sharply to the west and disappears into a culvert, which takes it under the major roads and railway lines to the north of Wolverhampton, as well as under the BCN Main Line canal.  It emerges by Wolverhampton Racecourse at Dunstall, where a small lake provides both flood relief and a wildlife haven. It is then taken over the Staffordshire and Worcestershire Canal by an aqueduct, the Dunstall Water Bridge.  The aqueduct was provided by James Brindley to maintain the flow of water in the Smestow and the Stour, both important sources of power to 18th century industry. The Smestow then descends to the level of the canal.  The Smestow runs down the length of the Smestow Valley Local Nature Reserve, under the main Wolverhampton – Tettenhall road, and past Tettenhall Station, formerly on the Wombourne Branch Line but now a ranger station.  Here the valley is hemmed in on both sides by steep slopes. The brook flows between the Wolverhampton suburbs of Compton and Tettenhall, being joined by the Graiseley Brook and the Finchfield Brook, which drain areas to the south-west of Wolverhampton city centre.

The Graiseley Brook is a small river that drains the area. It originally rose to the rear of the present Merridale School site and flowed across the Merridale and Compton areas to join the Smestow Brook, part of the River Severn catchment. Much of the course is now culverted.

There is some evidence of prehistoric rambling taking place in the area and it is likely that there would have been a very small local settlement. In 1928 half a sandstone axe head from about 1200 B.C. was found in the Wolverhampton Grammar School playing field near Graiseley Brook at Merridale.



It passes through Wightwick, where it is overlooked by Wightwick Manor.   At Wightwick the brook begins to diverge for some kilometres from the route of the canal, just south of the main Wolverhampton to Bridgnorth road. Although mainly inaccessible to the public, the green trail of the river is easily visible for some distance as it snakes across open farmland.  The innocent looking Trescott Ford is notorious for catching unwary motorists after heavy local downpours.  Passing through the hamlet of Furnace Grange, the Smestow takes a turn southward as it is joined from the right by the Black Brook, a considerable tributary.  The brook swings south-east through the village of Seisdon, where it flows between properties, bordering their gardens.  The same is true at Trysull. It then turns definitively south, grazing the south-western edge of Wombourne, where it used to cause major flooding problems until its course was reshaped in the 1990s. Here it is joined by its most important tributary, the Wom Brook. From this point the Smestow again runs within a few hundred metres of the Staffordshire and Worcestershire Canal.  Passing the hamlet of Smestow it runs to Swindon, from where it shadows the canal very closely, sometimes separated from it only by the width of the towpath. Here the reinforcement of the banks (to prevent collapse during flooding) is very evident. The meandering course crosses open farmland but is mostly screened from it by linear woodland. At Greensforge it passes a former Victorian corn mill, marking the site of one of the most important forges of earlier centuries, but now converted to apartments.  The valley narrows considerably between steep sandstone ridges after the river passes through Ashwood. The marina at Ashwood coincides with the descent of the Dawley Brook to join the Smestow. This confluence provided Roman soldiers with a natural moat to protect one of the forts, which are generally named after Greensforge.  At Gothersley, just south of Ashwood, the Spittle Brook joins from the right. Here the two streams water a small but valuable area of wetland.  Finally, at Prestwood, close to Stourton and Kinver, the Smestow enters the Stour. After rain, the darker material from upstream shows up very clearly as it flows into the sandy Stour. The Stour swings south, taking the Smestow's course, to join the River Severn at Stourport-on-Severn: its waters ultimately discharge into the Atlantic Ocean via the Bristol Channel.

The Birmingham Plateau is an upland area that has been cut off by the valleys of the Trent, Severn and Avon and their tributaries, and which has been split into the South Staffordshire and East Warwickshire plateaus by the valleys of the lower Tame and Blythe rivers. The South Staffordshire Plateau itself can be divided into major units of based upon river basins, plateaus and ridges.  Thus there are Cannock Chase High Plateau, the South Cannock Plateau, the Sutton Plateau, the Upper Tame Valley'

The Sedgley-Northfield Ridge forms the main English watershed as far as Frankley Beeches. Springs and rivers on one side drain to the Bristol Channel and those on the east drain towards the North Sea.

South of Aldersley, the canal begins to shadow the River Smestow, part of the Severn catchment. The Smestow crosses the canal via the Dunstall Water Bridge, a small aqueduct planned by Brindley to preserve the flow of the river, before dropping into the valley and running between the steep hillsides of Compton and Tettenhall, through the Smestow Valley Local Nature Reserve, the canal reaches Wightwick. Here it bears south, cutting across a wide bend in the course of the Smestow. Descending sharply through the impressive Bratch locks, the canal rejoins the River Smestow just south of Wombourne. From here it follows the river very closely to its confluence with the Stour near Prestwood.