It has borders with the Chakwal, Attock, Kohat,[3] Karak, Lakki Marwat, Dera Ismail Khan, Bhakkar,[4] and Khushab districts.

Mian Ali Mianwali was a known settlement and an agricultural region with forests during the Indus Valley Civilization (c. 3300 – c.1300 BCE).

Mughal emperor Babur mentioned Isakhel in the Baburnama when describing his campaigns against the Malik Awans and Niazi Pakhtuns during his invasion of Punjab in the 1520s.

Contingents raised from the neighborhoods of Bannu and Dera Ismail Khan marched under Nadir Shah's banner to the sack of Delhi.

In 1748, a Durrani army under one of Ahmad Shah's generals crossed the Indus at Kalabagh, and drove out the Ghakkars, who still ruled in the cis-Indus tracts of the district, owing nominal allegiance to the emperor at Delhi.

Their stronghold, Muazzam Nagar, was razed to the ground, and with their expulsion was swept away the last vestige of the authority of the Mughal emperor in these parts.

During the British Raj, the Mianwali district was also among the states of the British Punjab where regional offices of East India Company were in position until winter of 1883 when the regional office of East India Company in Mianwali was shut down due to civil unrest and hostile conditions.

[6] The British had made the town of Mianwali as tehsil headquarters of Bannu District then part of Dera Ismail Khan Division of Punjab province.

On January 14, 2023, CM Pervaiz Elahi announced that Mianwali and Bhakkar districts upgraded to divisional status, carved from the Sargodha Division.

[13] Mianwali district has an extreme climate with a long hot summer season and dry cold winters.