The Rhode Island towns of Tiverton and Little Compton, located in Newport County, are often included within the South Coast designation due to regional similarities with adjacent communities.

The "South Coast" label was born as a public relations effort to counteract the perceived stigma of former terms like "Greater Fall River," "Greater New Bedford," or "New Bedford-Fall River," which conjured images, in many Massachusetts residents' minds, of depressed mill towns with run-down buildings and high unemployment.

By its most literal definition, the South Coast only includes cities and towns in southern Massachusetts that may not be considered parts of the Providence Metropolitan Area, the South Shore or Cape Cod; it encompasses the geographic area of Massachusetts that borders Buzzards Bay (excluding the Elizabeth Islands, Bourne and Falmouth), Mount Hope Bay and the Sakonnet River.

Little Compton and Tiverton Rhode Island are often considered parts of the South Coast due to proximity and shared regional heritage; it has been argued that Little Compton and Tiverton share more in common with the regional identities of Westport and Dartmouth (and to an extent Fall River) than the rest of Newport County.

On February 27, 2023, MassDOT initiated a project to demolish the southern end of Route 79 in order to facilitate the restoration of Fall River's waterfront.

[12] The project will restore passenger rail service between Boston and the cities of Taunton, Fall River, and New Bedford, via the towns of Berkley and Freetown.