Geographically, Old Southwest is defined by the city as the area bound by Jefferson Street (Virginia State Route 116) on the east, 10th Street to the west, the Norfolk and Western railroad tracks to the south and both Day and Marshall Avenue to the north.

[3] The neighborhood is predominantly residential with commercial generally concentrated along and east of Franklin Road.

The neighborhood features a variety of architectural styles including but not limited to Queen Anne, Colonial Revival, Neoclassical, Bungalow, American Foursquare, Arts and Crafts and Shingle,[4] in addition to Roanoke's first public park, Highland Park, opened in 1901.

[5] Old Southwest would grow to become one of Roanoke's premier residential areas from its initial establishment through the years following World War Two when it would see the beginnings of a decline.

[6] The neighborhood boasts a number of carefully preserved historic buildings, including the Beth Israel Synagogue.