Mount Kumotori, Tokyo's highest peak at 2017 m, divides Okutama from the Okuchichibu region of the neighboring Saitama and Yamanashi Prefectures.

People began settling in Okutama from before the Jōmon Period and many archaeological sites have been found with ancient pottery.

[11] During the Edo period, the area included in present-day Okutama was divided into 16 villages within Musashi Province.

[11] Okutama has a mayor-council form of government with a directly elected mayor and a unicameral town council of 12 members.

Okutama, collectively with the municipalities of Akiruno, Fussa, Hamura, Hinode, Hinohara and Mizuho, contributes two members to the Tokyo Metropolitan Assembly.

In terms of national politics, the city is part of Tokyo 25th district of the lower house of the Diet of Japan.