Historically, the peoples of the East have been settled in Cameroonian territory for longer than any other of the country's many ethnic groups, the first inhabitants being the Baka (or Babinga) pygmies.

The southwest region is the most endowed with natural resources like oil, timber and plantain plantation The soil of the East is predominantly ferrallitic, rich with iron and red in colour.

Almost the entire territory of the East Region lies on the South Cameroon Plateau that forms the southeastern half of the country.

Humidity and cloud cover are relatively high, and precipitation averages 1500–2000 mm per year except in the extreme eastern and northern portions, where it is slightly less.

Approximately the lower two thirds of the region is covered in rain forest, which grows progressively thicker as one travels south.

The forests are composed of hardwood evergreens of species such as dibetu, ebony, iroko, mahogany, obeche, and sapelli, some of which grow to heights of 70 metres or more.

In areas closer to settlements and roads, human groups have harvested the larger trees, thus exposing the forest floor to more direct sunlight and allowing thick vegetation to thrive.

These factors also make the East an unattractive target for development by both non-governmental organisations and the Cameroonian government, a fact that has only further prevented larger numbers of people from settling in the region.

The majority of the inhabitants of the East are members of Fulani (Fulbe) and various Bantu tribes that are collectively known as the Beti-Pahuin (Béti-Pahouin), the Fang-Beti, or simply the Fang.

The Maka form the majority of this group and occupy much of the western territories on the border with the Centre Region, including the towns of Abong-Mbang, Nguelemendouka, and Doumé.

Though the capital, Bertoua, is a traditional Gbaya settlement, the region is today a melange of several tribes, including the Baki, Pori, Bajem, and Kwa.

The southwestern portion of the Lom and Djerem division, just west of this, is peopled by the Eki, who have more extensive territories in the Centre Region.

The rest of the region, that which is covered by thick forests and not serviced by roads, is inhabited by the Baka, Babaya, or Babinga pygmies.

Though traditionally hunter-gatherers, in recent times, the Baka have established trade with their Bantu neighbours, exchanging wild game for crops or metal tools.

This relationship is not always equal, however, and Bantu sometimes take advantage of the Baka, exploiting them for labour or ceding their territory to logging companies without compensation.

Farmers also raise many other crops in smaller quantities, including bananas, groundnuts, cocoyams, manioc, pineapples, oranges, mangoes, and yams.

At the start of the wet season, spices and common vegetables are planted close to the home and tubers, such as cocoyams and manioc, are placed with plantains in larger plots farther afield.

No large-scale commercial livestock exists in the East, though cattle from the northern regions of Cameroon are herded through the province on their way to market in Yaoundé.

While gathering of various wild plant species is primarily a female occupation, hunting is conducted by men with traditional implements such as bows and arrows, spears, blowguns, and traps.

Because of the rapid rate of exploitation, however, lumber companies have been forced to push further and further into Central Africa to find suitable trees.

In recent years, speculators have found deposits of gold near Bataré-Oya, cobalt near Lomié, and iron and aluminium in other areas.

In 2003, for example, CIAD and other NGOs began a gorilla habituation project to pave the way for camera-toting tourists to come within a few metres of the animals to see them in their natural environment.

In addition to the transportation network, the construction of the Chad/Cameroon pipeline has fueled the increase of Prostitution along these routes, with professional sex workers operating in virtually every town and village along the province's roads.

Archaeological finds around Batouri, Bertoua, and Bétaré-Oya attest to human presence in the territory of the East Province since prehistoric times.

The Maka stayed to occupy the territories surrounding what is now Massaména and Abong-Mbang, and the Njem settled around present-day Mindourou and Lomié.

Of these, the Maka-Njem moved into the territory first, after being forced from their home north of the Lom River by migrating Beti-Pahuin peoples, themselves fleeing the Vute, Mbum, Gbaya, and, ultimately, the Fulani.

The Maka stayed to occupy the territories surrounding what is now Massaména and Abong-Mbang, and the Njem settled around present-day Mindourou and Lomié.

For the five centuries or so since the Portuguese first reached the coast of present Cameroon, European explorers made little attempt to push into the intererior.

The region was a source of slaves, which were shipped out via the port at Douala or via the Congo River, though the numbers of natives taken were much smaller than in areas closer to the coast.

The French divided Cameroon into nine administrative areas, and most of what is now the East Province fell into the Doumé-Loume-Yokadouma district with its capital in Doumé.