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This region stretches from east to west, bordering Indian towns and villages. The home of the predominantly people of Nepalese origin, the five districts that constitute the region offer a proposition that is vastly different from the rest of Bhutan. The dress, food, language, customs, folk dances and songs, architecture, and even wildlife and vegetation are examples of a rich composite that evolves with cross-border cultural interactions that go back centuries.

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The Manas Wildlife Sanctuary (the only protected area in the world which has six big cat species sharing the same habitat); the border towns of Samdrup Jongkhar, Gelephu and Phuentsholing; commercial hubs; semi-tropical flora and fauna; neighbouring Indian towns, villages and tea gardens; Toorsa Strict Nature Reserve; hydropower projects.