Neighboring districts, clockwise from the north, are Ludwigslust-Parchim (in Mecklenburg-Western Pomerania), Ostprignitz-Ruppin (Brandenburg), Stendal (Saxony-Anhalt), and Lüchow-Dannenberg (Lower Saxony).

The term Prignitz originally meant the region north of the confluence of the Elbe and Havel rivers.

The historical region Prignitz consisted of the following eleven districts, established in the 13th century: Wittenberge, Lenzen, Perleberg, Putlitz, Kyritz, Nitzow, Wittstock, Pritzwalk, Havelberg, Wusterhausen and Grabow.

The western half was dominated by robber barons, especially the Gans zu Putlitz family and their vassals, the von Quitzows.

The wavy separation between the top and bottom symbolizes the river Elbe; the colors red and white are those of Brandenburg.