The region consists of six prefectures: Akita, Aomori, Fukushima, Iwate, Miyagi and Yamagata Prefectures.

The last stronghold of the indigenous Ainu on Honshū and the site of many battles, Tohoku retains a reputation as a remote region, offering breathtaking scenery but a harsh climate. The haiku poet Matsuo Basho wrote Oku no Hosomichi (The Narrow Road to the Deep North) during his travels through Tōhoku.

Tohoku, like most of Japan, is hilly or mountainous, with the ÅŒu Mountains running north-south. Its initial historical settlement occurred between the seventh and ninth centuries, well after Japanese civilization and culture had become firmly established in central and southwestern Japan. Although iron, steel, cement, chemical, pulp, and petroleum-refining industries began developing in the 1960s, Tohoku was traditionally considered the granary of Japan because it supplied Sendai and the Tokyo-Yokohama market with rice and other farm commodities. Tohoku provided 20 percent of the nation's rice crop. The climate, however, is harsher than in other parts of Honshu and permits only one crop a year on paddy fields.
Cast iron teapots like this one sit atop stoves during the long winters in Tohoku.

The inland location of many of the region's lowlands has led to a concentration of much of the population there. Coupled with coastlines that do not favor seaport development, this settlement pattern resulted in a much greater than usual dependence on land and railroad transportation. Low points in the central mountain range fortunately make communications between lowlands on either side of the range moderately easy. Tourism became a major industry in the Tohoku region