Neighbouring provinces are (from north clockwise) Nakhon Sawan, Chai Nat, Suphan Buri, Kanchanaburi and Tak.

[5] The province stretches from the upper plains of the Chao Phraya River valley, to forested mountains in the west.

[1] The Huai Kha Khaeng wildlife sanctuary, at the western boundary bordering Tak province, was declared a World Heritage Site in 1991.

The Patabeut people, of Karen ethnicity, revived the settlement at its current site during the Ayutthaya Kingdom.

In 1892, King Chulalongkorn (Rama V) added the area of Uthai Thani to the Monthon Nakhon Sawan and in 1898 formed the province.

As of 26 November 2019 there are:[8] one Uthai Thani Provincial Administration Organisation (ongkan borihan suan changwat) and 14 municipal (thesaban) areas in the province.

The non-municipal areas are administered by 49 Subdistrict Administrative Organisations (SAO) (ongkan borihan suan tambon).