Other important population centres include the cities of Kimberley and Fernie, and the district municipality of Invermere and Sparwood.

Despite its name, the regional district does not include all of the region known as the East Kootenay, which includes the Creston Valley and the east shore of Kootenay Lake.

Another distinct area within the regional district is the Elk Valley in the southern Rockies, which is the entrance to the Crowsnest Pass and an important coal-mining region.

Other than the Columbia and Kootenay Rivers, whose valleys form the bottomlands of the Rocky Mountain Trench, also included in the regional district are the northernmost parts of the basins of the Flathead, Moyie and Yahk Rivers (the Moyie and Yahk are tributaries of the Kootenay, entering it in the United States, and the Flathead is a tributary of the Clark Fork in Montana).

[14] Primary health centers are present in Sparwood and Elkford.