As the name suggests, it is atop a hill on the north side of Spokane, within which it is centrally located and crossed by numerous major thoroughfares.

The historic Garland Theater is located in North Hill, and the city's main north–south arterial, Division Street, is home to a major commercial district along the eastern edge of the neighborhood.

The streets delineating the eastern and western borders carry major north–south thoroughfares that connect downtown in the south with the northern side of the city.

Francis Ave. in the north and Wellesley Avenue through the middle are major east–west thoroughfares that connect across the northern side of the city.

[1] The neighborhoods adjacent to North Hill are Emerson/Garfield to the south, Audubon/Downriver and Northwest to the west, Balboa/South Indian Trail and Town and Country to the north, Nevada Heights to the east, and in the southeast corner Logan lies diagonally across the intersection of Division St. and Euclid Avenue.

It grew into the neighborhood's main center and remains to this day and important and historic commercial district in Spokane.

Madison Elementary is located in the northeast of the neighborhood and serves that area from Division in the east, Francis in the north, Monroe on the west and Wellesley on the south.

Willard is located in the southern half of the neighborhood and serves it between Wellesley on the north and the bluff on the south.

Here, east to west, only Division, Post, Monroe, Courtland, Maple and Ash climb the bluff into North Hill from Emerson/Garfield.

[9] Bicycles are prohibited on Division through North Hill, and the only dedicated bike lane in the neighborhood is located on Rowan.

Shared roadway bike routes run along Cora and Courtland east of Cedar, and up Cedar north to Garland, as well as along Wall north of Garland, Rowan east of Monroe and Central west of Wall.

[10] The Spokane Transit Authority, the region's public transportation provider, serves North Hill with six fixed schedule bus lines.