After fleeing from Phrae, deposed king Phiriya Thepphawong escaped from Northern Thailand to Luang Prabang, residing in Xam Neua from 1903-1909.

At 05:45 and 17:45 each day there are public addresses from loudspeakers atop a tower on the school playground, expounding on communist life and philosophy.

[citation needed] It is said that there is a communist re-education camp in Xam Neua and that it was the Pathet Lao capital during the Laotian Civil War Battle of Lima Site 85 (LS-85), 11 March 1968.

It is near the Pathet Lao refuges in the Viengxay caves, which the Lao government hopes to promote as a tourism destination similar to the Củ Chi tunnels near Ho Chi Minh City in Vietnam and the Killing Fields Memorial near Phnom Penh in Cambodia.

It is near Nam Et-Phou Louey National Protected Area (pronounced "naam et poo loo-ee").