He used the word Pactyans (pashto-پاکتیان) for Pashtuns who lived in Loy Paktia (which includes modern Afghanistan and Pakhtunkhwa regions).

Some of the more notable leaders include Najibullah Ahmadzai (a former President of Afghanistan), Mohammad Aslam Watanjar, Shahnawaz Tanai, and Sayed Muhammad Gulabzoi.

Between 7 and 8 January 1988, in Paktia Province, near the Pakistani–Afghan border, the Battle for Hill 3234 took place, which was a successful defensive action fought by the 345th Independent Guards Airborne Regiment, 39 Soviet Airborne Troops, in Soviet occupied Afghanistan against a force of up to 200 to 250 Mujahideen rebels.

Shortly after landing, the airborne troopers, who were well trained and experienced in Afghan conditions, started to take up positions which covered both the road and the uphill passages.

After a few salvos, Soviet artillery replied and silenced some of the mujahideen's guns, with the commander of the first platoon, Lt. Viktor Gagarin, directing fire via radio.

Attacks were made from two directions, indicating that the assailants may have been assisted by rebels trained in Pakistan by American agents.

During the ensuing battle, the Soviet unit was in constant communication with headquarters and received everything the leadership of 40th Army had to offer in terms of artillery support, ammunition, reinforcements, and helicopter evacuation of the wounded.

[7] The exhausted and mostly wounded Soviets were nearly out of ammunition but continued to occupy the hill until the last convoy passed through the road below.

[8][9][10][11] Immediately after the fall of the Taliban government, Paktia was one of the most chaotic regions in the country, as a small civil war broke out between rival militia commanders for control of the province, and Taliban and al-Qaeda fighters gave occupying U.S. troops some of their heaviest losses in the cave complexes south of Gardez.

[12] Paktia was the site of heavy fighting between Taliban insurgents and ISAF-backed Afghan National Security Forces.

Forces loyal to Zadran attacked Gardez several times and were resisted by Saifullah's militia, leading to many people being killed.

[13] February 2003, the 1st Provincial Reconstruction Team (PRT) in Gardez commenced with the objective of providing funding for local Afghan projects concurrent to a reinforced security presence in overwatch.

The PRT Gardez composition includes a reinforced platoon from the 504th 82nd ABN along with US Army Civil Affairs contingent plus Special Forces.

In March 2003, USAID and State Department representatives joined the 1st Provincial Reconstruction Team (PRT) in Gardez.

In September 2006, Governor Hakim Taniwal was killed by a Taliban suicide bomber as he left his office in Gardez.

On 12 February 2010, five civilians including two pregnant women and a teenage girl were killed by U.S. special forces during the Khataba raid.

[19] After some early unrest a long period of relative calm followed, despite the occasional high-profile incident such as the 2006 assassination of the governor, by a suicide bomber.

Some regions of Paktia are also believed to be a safe haven for militants from the Haqqani network, an anti-government combat organisation involved in the Taliban insurgency.