The capital of the province is Buala on Santa Isabel Island, which has scheduled airline services to Honiara on Solomon Airlines from Fera Airport, on Fera Island, a 15-minute boat ride from Buala.

The province has an economy dominated by subsistence agriculture with occasional plantations for cash crops such as copra, and by logging activities.

The province is seldom visited by tourists due to poor infrastructure, lack of roads, hotels, modern medical care, and endemic malaria.

Most areas have a "Rest House", a house where guests can seek accommodation for the night or two, but many residents are willing to take in visitors for the night.

The first European contact to the Solomon Islands was made by Spanish navigator Álvaro de Mendaña de Neira in 1568, who gave them their name because he left Spain on Santa Isabella's day.