Almost all of the region is formed by Bunter sandstone and this defines both its relief and the surface of the land apart from occasional layers of overlying volcanic basalt.
Between the Hoher Meissner (754 m) and Kaufungen Forest (up to 643 m high) in the north, the Knüll (636 m) in the centre, the Vogelsberg (773 m) in the southwest and the Rhön (950 m) in the southeast, there are numerous individual singularities which catalogue the volcanic activity between the two Central Uplands regions.
South of the Fulda-Haune Plateau and west of the Rhön are the Lower und High Vogelsberg hills, the former encircling the latter.
The most important rivers of the East Hesse Highlands are listed in the following table, in clockwise order, beginning on the north side of the Rhine-Weser watershed by the Vogelsberg.
River names and lengths listed in italics are those which clearly leave the region of the East Hesse Highlands (depressions on the perimeter excluded), where catchment areas and discharges are given in italics, it indicates that part of the catchment area is external and has significant tributaries from outside the East Hesse Highlands (see the notes below the table).