Over the centuries the river was an important trading route. In the 14th Century Ashford Carbonnel mill was constructed from Caen, Normandy stone transported up the Severn and Teme. Until the railways arrived in the valley small barges or Trows sailed up with cargoes of wheat for the mills and general goods for the towns. An 1840s painting shows four square rigged trows unloading at Dinham Mill, now Mr Underhill's Restaurant. Another Trow under full sail is moving upstream probably to Downton Gorge for a cargo of iron billets. These were taken to the Severn and up the Stour to Wolverley to be rolled into bars and strip products. Some iron was stored in a warehouse still existing in Eastham for use by village blacksmiths.
Through navigation ceased when Powick Power Station Turbines were installed in the 1890s and the weir and lock on Powick Ham were removed to deepen the channel to improve the water flow. The Teme is still a statutory navigation much enjoyed in canoes and coracles from Leintwardine to the Severn.