Starting in Lake County as East Vermillion River, the Vermillion itself flows almost due south through the Dakota Heritage & Lakes Region. It passes under I-90 near Montrose to form Lake Vermillion, where you will find Lake Vermillion Recreation Area. It then flows through Centerville and joins the Missouri River at Vermillion.
The river itself was first noted on an 1801 map by a French trapper who called it Otter Stream. In Lakota language, Vermillion means "red paint." Some say the stream is named for the outcropping of red quartzite along its bank.