Mizuho is located in the foothills of the Okutama Mountains of western Tokyo, bordered by Saitama Prefecture to the north.

Saitama Prefecture Tokyo Metropolis Mizuho has a humid subtropical climate (Köppen Cfa) characterized by warm summers and cool winters with light to no snowfall.

Mizuho has a mayor-council form of government with a directly elected mayor and a unicameral town council of 16 members.

Mizuho, collectively with the municipalities of Akiruno, Fussa, Hamura, Hinode, Hinohara and Okutama, contributes two members to the Tokyo Metropolitan Assembly.

JR East – Hachikō Line The town in the romance visual novel and anime Clannad, by Key, draws inspiration from locations in Mizuho.