Largely single-family residential, Northwest is also home to Spokane's VA Medical Center, the Dwight Merkel Sports complex, a large public sports facility, and portions of Riverside State Park along the Spokane River.

[2] They camped and fished along the banks of the Spokane River and gathered edible plants, roots and berries which grew throughout the neighborhood.

[3] With the arrival of European settlers in the 1800s, the trail became an important arterial for the trappers and pioneers who came to the Spokane area.

The trail was renamed Pioneer Road and was part of a route that connected the Columbia River to Spokane House, roughly 7.5 miles to the northwest of the current neighborhood.

During World War II the U.S. Army built Baxter General Hospital on the grounds of what is now the VA Medical Center.

[3] In the post-war housing boom that followed, residential development spread across the north side of Spokane, including in the Northwest neighborhood.

There is a hillside that runs southeast–northwest along Driscoll Boulevard that climbs approximately 100 feet over two to three city blocks.

Another, steeper bluff falls more than 100 feet just northwest of the intersection of Francis and Nine Mile Road, where the northwesternmost portion of the neighborhood lies closer to the elevation of the Spokane River.

[8] Riverside State Park extends into Northwest along its western boundary on the Spokane River.

Tall ponderosa pine trees in the neighborhood are remnants of the ecoregion's presence prior to human development.

Browne Elementary serves the neighborhood south of Rowan Avenue and west of Belt Street.

[8] The easternmost portions of Northwest are aligned to the city's street grid, though it breaks down as one moves west and the terrain becomes less flat.

The Aubrey L. White Parkway, passing through Riverside State Park and paralleling the Spokane River, as well as A and Belt Streets, are classified as major collectors by the city.