The district contains Manchester, New Hampshire's most populous city, and its immediate suburbs.

Most of the district's population resides in Rockingham County, which includes much of the Seacoast Region.

The northern part of the district in Belknap, Carroll, and Grafton counties are far more rural.

During the mid-2000s and the 2010s, the district was extremely competitive, having changed hands in five of the last eight elections, with an incumbent losing reelection each time.

The streak was broken in 2020 when incumbent Democrat Chris Pappas won reelection; he later won reelection again in 2022, becoming the first representative elected to a third consecutive term in the district since John E. Sununu.