The river begins its life as the Ballynahinch River which flows from west of the town of Ballynahinch to Annacloy where it is known as the Annacloy River. This then becomes the Quoile proper, which flows through Downpatrick and the Quoile Pondage before finally emptying into Strangford Lough.
In October 1991, during dredging operations in the river, a piece of oak, perhaps the remains of a log-boat, was found. Following dendrochronological dating it was found to have a Neolithic date of 2739 BC.
On the north bank of the river, 0.75 miles (1.2 km) north-west of Downpatrick, the Inch Abbey site was originally on an island (Irish: Inis) in the Quoile Marshes. The pre-Norman Celtic monastic settlement here, known as Inis Cumhscraigh (or Inis Cuscraidh), was in existence by the year 800. In 1002 it was plundered by the Vikings led by Sitric, King of the Danes, who came up the Quoile with a fleet from the sea. The Vikings plundered the settlement again in 1149. The Cistercian Inch Abbey monastery, founded by John de Courcy in 1180, is located near to the river in the southern area of the Early Christian earthwork enclosure.
Quoile Castle is situated 1.5 miles (2.4 km) from Downpatrick, just off the main road from Downpatrick to Strangford, on the east bank of the river. It is a 16th-century Tower house which was inhabited into the 18th century.
The Quoile Pondage National Nature Reserve is situated just outside Downpatrick on either side of the Quoile River. It was created in 1957 by the construction of a tidal barrier to prevent flooding in the Downpatrick area. Soon after the barrier was built, plants and trees colonised the former seashore. Facilities at the reserve include the Quoile Countryside Centre with displays on the wildlife and history of the area. There are also many features of historical interest within the reserve including Quoile Quay situated close to the Centre, which itself is just beside Quoile Castle.
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