The urban area is surrounded by the Chugoku Mountains in the northwest, the Oze River in the south, and the Seto Inland Sea in the east, and develops into flat land along the coastline.

After the start of the Edo Period, Fukushima Masanori built a Kamei Castle to defend against the Mōri, but was forced to dismantle it in 1611 by the Tokugawa shogunate.

In 1923, Shinkin Rayon, the predecessor of Mitsubishi Rayon (currently Mitsubishi Chemical) established a major factory in the town, and the Imperial Japanese Navy Naval Infantry established a diving school.

In 1945, Ōtake was a major port of entry for Japanese who had been deported from the Empire of Japan's former overseas territories.

Ōtake has a mayor-council form of government with a directly elected mayor and a unicameral city council of 16 members.

In terms of national politics, the city is part of the Hiroshima 2nd district of the lower house of the Diet of Japan.