These features of the Cem's basin have their origin in the tectonic activity of the Alpine orogeny, which formed the Dinaric Alps.

The Cem basin was the home of Albanian tribes (fise) such as Kelmendi, Hoti, Gruda and Triepshi until the 20th century.

The river's basin is a source of very high biodiversity, and hundreds of plant and animal species live along its banks.

[1] Albanian Cem and medieval Slavic Cenva and Cemva ultimately stem from this original name of the river.

[2] Montenegrin– and also Bosniak and Serbian – Cijevna is derived from Serbo-Croatian cijev (pipe), but other toponyms preserve the older name Ćemovsko polje (field of Cem).

[3] The Vukël Cem – the more important of the two in terms of water volume – rises at 900 m (3,000 ft) above sea level and flows for 17.9 km (11.1 mi).

[4] The Selcë Cem rises at 1,250 m (4,100 ft) on Mount Bordolec near Lëpushë and flows for 22.5 km (14.0 mi) mostly through narrow limestone terrain until it reaches the valley of Tamarë.

Firstly, it forms a steep canyon and then slowly crosses into the Zeta plain, of which a part is called Ćemovsko polje after the river.

The canyon starts at the Albania-Montenegro border and forms a distinct geomorphological formation that crosses into Ćemovsko polje just before the village of Dinosha.

[5] The geomorphological features of the Cem basin have their origin in the tectonic activity of the Alpine orogeny, which has been forming the Dinaric Alps and its southern range, the Accursed Mountains since the Late Mesozoic and Cenozoic era.

[10] The result of these interconnected processes is that the Cem flows mostly through elevated, vertical and steep terrain, which forms canyons and crosses into small valleys.

Then, the river exits high elevation areas and flows towards the Morača as the relief flattens and a polje is formed by karst processes.

Short-toed snake eagles, Levant sparrowhawks and the rock partridge use the canyon for breeding and nesting in the summer months.

[27] Until the 1990s, Kelmendi's geographical position as a heavily guarded border zone and lack of industrial development preserved the Cem's ecosystem.

Ecological indicators and water quality assessment have consistently shown that the Cem is one of the least polluted rivers in the country.

Within Albania, in recent years, the Cem's ecosystem and very high biodiversity have been threatened by the planned installation of 14 small hydropower plants.

[30][31] In Kelmend, locals have protested strongly against the projects as water used for irrigation will be significantly reduced, and the impact on the ecosystem will endanger ecologically sustainable development in the entire area.

In Podgorica, after protests by environmental activists, the Montenegrin government requested full documentation of the Strategic Impact Assessment of the proposed hydropower plants on the river flow as both countries have signed the Espoo Convention, which requires transnational consultation on projects that impact natural resources across borders.

[29] The same process of hydropower expansion is also planned for many of the free-flowing rivers of the Balkans including Morača, where the Cem debouches.

Environmental organizations argue that despite their formal commitment to protect the river's basin, Montenegrin authorities have consistently allowed sewage pollution, gravel exploitation and unauthorized construction.

[33][34] In the lower part, beyond the canyon, industrialized agriculture and the Podgorica landfill have contributed to the deterioration of surrounding land quality.

As a result, there is a heavy migration flow towards Italy, Greece and particularly the US, where a large community from Tuzi and Malësia lives in Detroit.

Artefacts from this era have been excavated in Selcë, where a hoard of coins that were minted by king Gentius (181-168 BC) was found.

[42] The fort system was created after the Ostrogothic invasion of Dalmatia in the late 5th century, which turned former Praevalitana into a border area of the Eastern Roman Empire.

[44] The Albanian fis pattern of settlements on the banks of the Cem continued in the Ottoman period and even after the division of the river between Montenegro and Albania in the Balkan Wars.

The Ottomans placed the Cem area under the jurisdiction of the Sanjak of Scutari to control the Catholic clans of Malësia.

[46] Historical accounts of the Cem increased in the second half of the 19th century as the political rivalry of the Great Powers affected the region and the Principality of Montenegro expanded into Ottoman territory.

[47] For the next 30 years the Cem basin was fought over by the Ottomans, the Montenegrin Principality and the Albanian national movement, with ever-changing tactical alliances between those forces due to the involvement of Great Powers, Austria and Russia.

[48] The London Peace Conference of 1912-1913 set the Albanian-Montenegrin border which remains to this day the boundary that divides the Cem.

Tuzi municipality uses the river in its flag and in Ljajkovići, the local football club (FK Bratstvo Cijevna) is named after it.