The lowlands of the island are divided between secondary forest and a patchwork of farmland and plantations (notably including shade-grown coffee), while the highlands are mainly scrubland.

The island experiences a heavy dry season typical of northwestern Madagascar, and is dotted by bamboo and Fabaceae trees, alongside the non-native mango and jackfruit.

During the early 19th century, the region was heavily settled by Sakalava refugees and their slaves fleeing the hegemony of the Merina Kingdom.

The population of Nosy Komba, mainly restricted to the northern half of the island, relies on ecotourism and handicraft, supplemented by a wide range of agricultural products such as coffee, vanilla, cacao, and sugar cane.

A number of hotels and guest houses support tourists to the island, mainly on short excursions from Nosy Be.

Nosy Komba's lowlands are largely divided between farmland and secondary forests, while scrub predominates in the highlands.

[5] The island formed during or shortly after the end of the Cretaceous period 66 million years ago, as Madagascar separated from the continent of Africa.

[8][9][10] Expanding French influence over the region forced Tsiomeko and the Merina to cede a section of coast to France in July 1840, including both islands.

[11][12] French settler-colonial efforts on Nosy Be were persistently hampered by outbreaks of diseases such as malaria, cholera, and smallpox.

To remedy this, a convalescence retreat was built on the adjacent Nosy Komba in 1841, immediately following the French annexation of the region, with an upgraded facility constructed in 1876.

The location of the retreat on Nosy Komba's highlands was motivated by 19th century beliefs in the healing effects of high-altitude environments, alongside the existence of ample colonial labor to support the European settlers.

[12] In 1895, this retreat was further upgraded into a full sanatorium following widespread malaria outbreaks among French colonial troops during the Second Madagascar expedition.

[1] Like the rest of Sambriano, Nosy Komba hosts a population of the flowering plant Takhtajania perrieri, the only species of the family Winteraceae in Africa.

No official environmental protections exist on the island itself, although it hosts a traditionally-protected area of around 45 ha (110 acres) of old-growth indigenous forest.

Additionally, due to the island's small size, human activity alongside natural disasters such as severe storms may have had an intensified impact on local species.

However, some species of reptiles (notably the chameleon Calumma boettgeri) have experienced a considerable population rebound over recent decades.