Although it does not contain the highest peak, the Courtois Hills has most rugged terrain and steepest average slopes of any region of the Missouri Ozarks.

The western frontier of the United States had crossed the Mississippi River and reached the edges of the Courtois Hills by 1811.

Settlers moved in to areas to the east, north, and west of the Central Plateau and its surrounding hills first.

The plateau received very slow and gradual immigration later, with settlement of the Courtois Hills occurring last.

[2] The best areas for agriculture are concentrated in the southern part of the region, where rivers have made the valleys wider.