The Eastern Region consists of 21 counties in the heart of the Red River Valley which was formed when the last ice sheet receded and became an immense glacial lake, Lake Agassiz. As the lake drained into the Hudson Bay, it left fertile black soil potent with minerals and organic matter and is now some of the best farm land in the state. Eastern North Dakota is known for towering shelterbelts, waving fields of wheat and an area that produces potatoes and sugar beets. Recreationally, the area has beautiful lakes, one of which is located in Devils Lake, with some of the best fishing in the country.

Three large tertiary care centers, two federally funded community health centers, 16 rural hospitals, and 27 rural clinics provide medical services to 52% of the state’s population. One Indian Health Service clinic serving the Spirit Lake Sioux Nation is also located in this region.

Approximately 25,000 students attend the state’s two largest universities offering diverse educational opportunities for undergraduate and graduate. The University of North Dakota, located in Grand Forks, has the state’s only medical school and law school while North Dakota State University in Fargo is noted for their excellence in all fields of agriculture, engineering and pharmacy education. The region also has three state colleges, one private college, and one technical educational institution with a variety of educational programs. Grand Forks is also home to one of two Air Force Bases in the state.