Sittwe is located on an estuarial island created at the confluence of the Kaladan, Mayu, and Lay Mro rivers emptying into the Bay of Bengal.

[3] The area of modern Sittwe was the location of a battle during the conquest of the Kingdom of Mrauk U (later Arakan and now Rakhine State, Myanmar) by the Burmese king Bodawpaya.

Saittwe or Sittwe was only a small fishing village at the time of the British conquest of Burma,[3] but its four poorly-maintained stupas Akyattaw, Thingyittawdhāt, Letyatalundaw, and Letwetalundaw were later claimed to date to the 16th century and to hold various relics of the Buddha: part of his rear jawbone, his thigh, his right shinbone, and his left shinbone respectively.

[7] Despite Morrison and many of his men succumbing to malaria, cholera, and other tropical diseases to the point the entire settlement was abandoned for a time,[7] the port was chosen to serve as Arakan's seat of government in 1826 largely because Mrauk U was considered even more unhealthy.

[3] The bell of the pagoda at the Mahamuni Buddha Temple south of Mandalay was removed to the basement of the Akyab courthouse until 1867.

[5] Despite its bad reputation for disease, historical records indicate Akyab was no more dangerous to its European colonizers than other locations along the India coast.

[4] During World War II, Sittwe was an important site of many battles during the Burma Campaign due to its possession of both an airfield and a deepwater port.

[11] In early 2024, as a result of the Myanmar Civil War, Sittwe was surrounded by Arakan Army forces, which gained control of most of Rakhine State.

[2] As of December 2024, Sittwe remains only one of three major towns in Rakhine state under junta control, along with Kyaukphyu and Manaung.

In October 2011, as part of a recent bilateral trade deal signed by Myanmar and India, the two countries pledged a US$120 million port and multimodal investment to complete the infrastructure linking Indian north-eastern provinces to Sittwe overland via India's Mizoram by 2013.

Once operational it will offer direct passage to enable Burmese and Indian shippers to pick up mainline services to and from Kolkata.

The 7,000-seat Wai Thar Li Stadium is the home ground of Rakhine United F.C., a Myanmar National League (MNL) football club.