Essequibo Islands-West Demerara is split in two by the Essequibo River. It is bordered by the Atlantic Ocean to the north, the region of Demerara-Mahaica to the east, the region of Upper Demerara-Berbice to the south and the regions of Pomeroon-Supenaam to the west. It contains the towns of Parika, Schoon Ord and Uitvlugt. It contains the large islands at the mouth of the Essequibo, including Hog Island, Wakenaam and Leguan. The Administrative centre is located in the town of Vreed-en-Hoop.

The Essequibo Islands-West Demerara Region is made up of the islands in the Essequibo River such as Leguan and Wakenaam, and the Western portion of mainland Demerara. It is made up of low coastland, hilly sand and clay, and a small portion of forested highland regions.

This Region's population live in villages, many along the coast. Rice farming is predominant, with small amounts of sugar and coconut cultivation.

The Boerasirie Extension Project converted the Boerasire Conservancy and the Canals Polder Conservancy into a single reservoir, and reclaimed thousands of hectacres of land, suitable for farming. The water from the conservancy is used during the dry seasons for irrigation.

Sugar cane and coconuts are cultivated on a smaller scale and there is also beef and dairy farming.