Its coastline forms part of the Sanriku Fukkō National Park, which stretches north to Aomori Prefecture.

The area of present-day Higashi-Matsushima was part of ancient Mutsu Province, and has been settled since at least the Jōmon period by the Emishi people.

On March 11, 2011, Higashi-Matsushima was severely hit by the 2011 Tōhoku earthquake and tsunami resulting in at least 1,039 deaths,[5] and the destruction of over 11,000 structures, or approximately two-thirds of the buildings in the city limits.

[8] Higashi-Matsushima has a mayor-council form of government with a directly elected mayor and a unicameral city legislature of 18 members.

In terms of national politics, the city is part of Miyagi 5th district of the lower house of the Diet of Japan.