Southside was one of the fountainheads for the Byrd Organization, and the region's Democrats began splitting their tickets in presidential elections as early as the 1930s.

The district was to be one of two in Virginia which gave a plurality of the vote to segregationist George Wallace in 1968, and has never supported a Democrat for president since Harry S. Truman in 1948.

Despite this, the congressional seat remained in the hands of Democrats who were very conservative even by Virginia standards.

After Hurt left office, the district continued to elect Republicans, including Tom Garrett, Denver Riggleman, who both served one term, and Bob Good, who was re-elected in 2022.

It covers all or part of the following political subdivisions: The entirety of: Portions of: 2024 Virginia's 5th congressional district election Republican John McGuire III, who had ousted Bob Good in the Republican primary, defeated Democrat Gloria Witt in the November general election on Tuesday, November 5, 2024.