Rousse region includes a part of the hilly Danubian Plain, part of Ludogorie lowlands, the Danubian riverside plain of Pobrezhie. It is bounded by the regions of Razgrad, Silistra, Targovishte and Veliko Tarnovo, and borders Romania to the north with the Danube River as a boundary. Some of the big rivers are the Yantra and the Rusenski Lom. The region is important for the national transport system. The Danube River is linked through the European waterway system with the Mein and the Rhine rivers and connects the North Sea with the Black Sea. Important roads and railways connect the region with the rest of the country and the only bridge over the Danube on Bulgarian territory connects the country with Romania. The first railroad line in Bulgaria - Ruse-Varna, built in 1866, crosses the region. The middle point of the bridge marks the boundary between the two countries. The central segment of the bridge can be raised to allow the traffic of bigger ships. Protected areas on the territory of the region include the Roussenski Lom Nature Park, which comprises the picturesque canyon of the river valley, rock formations near the villages of Pisanetz and Mechka, and the Orlova Chuka Cave.

Vestiges of prehistoric life in the region have been found in the Orlova Chuka Cave and in the mound of Rousse. Thracians, living in the area around the 4th c. BC, have left about 250 mounds. The Thracian silver treasure, discovered near the village of Borovo, known as the Rousse , Treasure, is notable for the fine skillful decoration of animals'figures and mythological scenes. The castles built during the Roman times to defend the Danube frontier include Sexaginta Prista (near Rousse), Jatrus (near the village of Krivina), Tigra (near the village of Marten), etc. The rock churches of Ivanovo are notable cultural landmarks of the region and they are included in the UNESCO List of World Cultural Heritage. The medieval fortress of Cherven can be also visited. In the 19th century Rousse is the gate for the European cultural influence on Bulgarian lands. The preserved patterns of urban architecture are among the most attractive and stylish throughout the country.