The Truckee River is the only outlet for Lake Tahoe, flowing out of the lake at Tahoe City.

While many streams and rivers flow into Lake Tahoe, the Truckee River is the sole outlet. It originates at the northwestern end of the lake near Tahoe City, California, and flows northeast through Nevada, eventually emptying into Pyramid Lake. The Truckee River plays a crucial role in the hydrology of the Lake Tahoe basin.