Before 2023, geographically, it was the eleventh-largest congressional district in the country and included much of the state outside the Phoenix and Tucson metropolitan areas.

From 2013 through 2022, it also included the Navajo Nation, the Hopi reservation, and the Gila River Indian Community, with 25% of the population being Native American.

The new 1st district (as of 2023) includes northeast Phoenix, Scottsdale, Paradise Valley, Cave Creek, Carefree, and Fountain Hills.

Over the years, the 1st's share of Phoenix was gradually reduced due to the area's explosive growth in the second half of the 20th century.

It includes the northeastern suburbs of Phoenix, Scottsdale, Paradise Valley, Cave Creek, Carefree, Fountain Hills, Rio Verde, and the Fort McDowell Yavapai Nation.