It borders Analanjirofo region in the north, Alaotra-Mangoro in the west, Vakinankaratra and Amoron'i Mania in the southwest, and Vatovavy in the south.

The region contains over 285km of coastline, which includes many beaches and cultural heritage sites.

[3] The current governor of Atsinanana is Richard Théodore Rafidison.

Atsinanana Region is divided into seven districts, which are sub-divided into 82 communes.

The remaining airports are unpaved pistes, without regular commercial flights: There is only one railroad line that leads to the capitol Antananarivo via Brickaville by Madarail but passenger services are only available up to Moramanga.