Later Zasechnaya cherta, a chain of fortification lines, was created to protect Grand Duchy of Moscow and later the Tsardom of Russia from the Crimean-Nogai Raids.

In 1221 Grand Duke Yuri II of Vladimir founded Nizhny Novgorod, later to become one of largest Russian cities, to protect the Oka's confluence with the Volga.

Due to the Oka's and Moskva's meandering courses, travel was not particularly fast: for example, it took Cornelis de Bruijn around 10 days to sail from Moscow down these two rivers to Nizhny Novgorod in 1703.

[14] The banks of the river are dotted with historical and cultural sites, including the medieval monasteries of Murom, the mosques and minarets of Kasimov, the fortified kremlins of Kolomna and Serpukhov, the memorial houses of Vasily Polenov and Sergey Yesenin, the excavated ruins of Old Ryazan and the Oka Shukhov Tower.

[citation needed] The Oka appears as the title and main theme in a popular, nostalgia-filled military field song written by Leon Pasternak of the Polish 1st Tadeusz Kościuszko Infantry Division, which was founded near the river in 1943.