[citation needed] Early peoples in North Sumatra consumed mostly snails and clams, leaving large shell deposits sometimes referred to as kjokkenmoddinger (kitchen waste), some of which are still found as hills in Saentis, Hinai, Tanjung Beringin, along the Deli-Langkat shore, and on riverbanks.

Their villages were scattered along the big rivers that flow to the east coast of North Sumatra such as Besitang, Wampu, Asahan, and Barumun.

Relics of the Mesolithic era have been found in North Sumatra, including finely honed stone axes, bone tools, and painting materials.

[9] Linguistic and archaeological evidence indicates that Austronesian speakers reached Sumatra from Taiwan and the Philippines through Borneo or Java about 2,500 years ago, and the Batak probably descended from these settlers.

Barus, a trading port on the western coast of Tapanuli, attracted Middle Age era traders in search of camphor, which was popular in Ancient Egypt.

Furthermore, the Negarakertagama epic by Mpu Prapanca from the 14th century list countries found in North Sumatra, Pane, Haru, Mandailing, Tamiang, Lawas, and Barus, which were mainly defeated by the Majapahit.

Coastal areas of North Sumatra felt economic impacts as the VOC subsequently reduced the presence of trade in Malacca and shifted resources towards Batavia.

[18] In the nineteenth century, the Dutch began to focus more on to areas outside Java, including North Sumatra, driving out British influence.

During the Padri War, in the years prior to 1860, Dutch forces arrived in South Tapanuki at the request of a local leader to provide protection.

Meanwhile, particularly after 1869, Dutch tobacco plantation activities expanded on the east coast, including the estab;ishment of Deli Maatschappij and London Sumatra, using land leased from the Malay sultans.

This first big wave of migration established substantial Javanese, Chinese, and Indian populations in North Sumatra that remain to this day.

[24] To opportunistic pergerakan militants (including Communist Party of Indonesia members Xarim MS and Luat Siregar), the revolutionary movement was seen as a means for East Sumatra to be freed from colonial rule and to join the larger Indonesian National Revolution.

[27] In addition to the Dutch, the NST state was supported by Malay aristocrats, most of the Simalungun rajas, some Karo chieftains, and Chinese groups who felt that the revolution threatened their interests.

[28] Following the Dutch-Indonesian Round Table Conference in late 1949, the Dutch withdrew military support for the State of East Sumatra and its local authority began to collapse.

The short-lived state was viewed with suspicion, and Dr Tengku Mansur entered into negotiations with Mohammad Hatta to reunify East Sumatra with the Republic of Indonesia in May 1950.

Other islands in North Sumatra include Imanna, Pasu, Bawa, Hamutaia, Batu Makelele, Masa, Bau, Simaleh, Makole, Jake, and Wunga [id].

[citation needed] Half of the province is located on a high plateau that runs along the Bukit Barisan mountains, from central North Sumatra to the western coast.

The tallest mountain in the province is Mount Sinabung in Karo Regency, at elevation around 2,460 metres (8,070 ft), the most active volcano in the region.

Lake Toba is the site of a supervolcanic eruption that occurred 69,000 to 77,000 years ago, estimated at VEI 8, that formed a climate-changing event.

It was reported in January 2024 that a group of 140 Rohingya people, consisting mostly of women and children had landed in Indonesia and been directed by the military to the North Sumatra region.

The Batak Toba, Pakpak and Simalungun tribes have a musical instrument called Gondang which is usually played during traditional ceremonies in marriage, death, and so on.

The prominent Mandailing buildings are called Bagas Gadang (house of Namora Natoras) and Sopo Godang (customary consultation hall).

This includes Saksang and Babi panggang karo, and in the Pakpak Dairi area, Pelleng is a very spicy popular typical food.

With a large population of Batak being Muslim, especially among Mandailing people, they have their own dishes such as Sayur daun ubi tumbuk or mashed-cassava leaf soup, Pora-pora, Salai ikan, Pakkat and others.

The Chinese have influenced the province's cuisine, examples are Cha Sio,Tau Kua He Ci, Popia, Bakpao, Teng-Teng, Chai Pao, Roti Kacang and Bika ambon which are dishes also popular elsewhere in Indonesia.

Asahan hydropower, which is the largest hydroelectric power plant on Sumatra Island, is located at Porsea in Toba Samosir Regency.

North Sumatra produces rubber, cocoa, tea, palm oil, coffee, cloves, coconut, cinnamon, and tobacco.

The increasingly higher economic performance of Sumatra and Java means that North Sumatran exports will be experiencing rapid growth.

The list below is the most known places of interest in North Sumatra: The modern Kualanamu International Airport was opened on July 25, 2013, and is located almost 40 kilometres from Medan.

There are under discussion to build Medan inner ring-road toll road, including an elevated tollway above Deli River to accelerate city traffic.