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The Ohio River ends at the confluence with the Mississippi River at Cairo, Illinois. This confluence borders Kentucky, Illinois and Missouri. Even though the Ohio River is much wider and carries more water than the Mississippi where they meet, the Ohio is considered the tributary to the Mississippi.
Quick Answer. The Ohio River runs in a northwest direction out of Pennsylvania from Pittsburgh, and then southwest until it joins the Mississippi River in Illinois. The river is formed by Allegheny and Monongahela rivers. More water from it feeds the Mississippi River than any other body of water.