Prominent rivers include the Shag, the Waianakarua, the Kakanui and the Waitaki. The Kakanui Mountains form the principal cordillera, rising at their highest point, Mount Pisgah, to 1,643 metres (5,390 ft). These are separated from the lower, parallel Horse Range by the upper valleys of the Waianakarua and Shag rivers.
The large east-coast town of Oamaru serves as North Otago's main centre. Other towns and settlements in the region include Alma, Totara, Teschemakers, Reidston, Maheno, Kakanui, Herbert (also known as Otepopo), Waianakarua, Hampden, and Moeraki, all on or close to the coast south of Oamaru. The coastal plain north of Oamaru has the settlements of Hilderthorpe and Pukeuri.
Inland settlements include Weston, Ardgowan, Windsor, Five Forks, Peebles, Papakaio, Duntroon, Kurow (on the south bank of the Waitaki), Omarama, and Otematata.
The area aspired to provincial status in the 19th century, but never attained this. Most of its territory belonged to the Waitaki County, and today is officially part of the Waitaki District. Some sense of regional identity survives in support of sport, notably the North Otago rugby team. In recent years[when?] the northwestern part of the area, including the towns of Omarama, Otematata, Kurow, and Duntroon have officially become part of Canterbury region, testing this sense of identity and raising the ire of many locals.
The rolling, tussock-clad hill country of North Otago provides the important agricultural base, originally through sheep-farming but now largely superseded by dairy. The generation of hydro-electricity in the Waitaki Valley has also drawn attention to the area (see Project Aqua), and tourism has grown in recent years.
