Bakouma was founded in September 1892, when a Belgian expedition under Commander Georges Adolphe Balat and Captain Georges Le Marinel set up a military post on the site of the present town. In July 1894 it became part of the French Upper Oubangui, then a district under French rule in 1944, and finally on 23 January 1961 - after the Central African Republic's independence from France - a sous-prefecture of Mbomou Prefecture. The Lengo Petroglyphs, a cluster of prehistoric rock engravings, sit nearby and testify to a much longer human presence. The Belgian, French, and CAR administrations are all recent chapters in a story whose first authors left their marks on stone and vanished without names.

The 1959-1961 French survey turned up the first evidence. The French Commissariat a l'energie atomique followed up. The Swiss company Alusuisse conducted small-scale mining in the 1970s. A Japanese team in the 1980s concluded that large-scale extraction was not commercially viable given the difficulty of transport. Paladin Energy of Australia expressed interest in the mid-2000s and walked away. Chinese interest came to nothing. In May 2006, a South African company called UraMin invested in 90 percent of the Bakouma uranium project, with the CAR government holding the remaining 10. The project covered ten separate areas of mineralisation and applied for licenses that would have extended it to 2,900 square kilometres. Production was expected to ramp up from 2009 and peak at 3,000 tonnes per annum in 2010. It did not. Areva acquired UraMin in a deal that later became one of the most notorious corporate fiascos in French mining history - Bakouma was one of the reasons.

In the 1990s, a former political prisoner named Jeanne-Marie Ruth-Rolland was elected deputy leader of Bakouma. She led a gold prospectors' consortium and was active in diamond mining in the surrounding region. She had survived imprisonment during Jean-Bedel Bokassa's dictatorship, later ran for president of the Central African Republic, and worked through her life on questions of women's leadership and mineral wealth in Bakouma. A monument was erected in her honour after her death. The town she led is remembered mostly for what is underneath it. Ruth-Rolland was remembered, for a while, for insisting that what was on the surface - the people, the prospectors, the women in the markets - mattered just as much.

From December 2018 to January 2019, heavy clashes took place in Bakouma between ex-Seleka militias and government forces. The government prevailed, and the ex-Seleka withdrew. Two years later, on 26 December 2020 - one day before the Central African general election - three UN peacekeepers from Burundi were killed in Dekoa and Bakouma by rebel attacks. On 29 December, government forces abandoned Bakouma after being surrounded by FPRC and UPC rebels. The town was recaptured by the Armed Forces of the Central African Republic and their allies on 10 May 2021. The violence was not directly about the uranium. It was about the usual things - control of territory, of roads, of the checkpoints where anyone transporting anything of value had to pass.

Bakouma sits on the Gboyo River at the northern edge of the Mbomou forest, which covers some 10,000 square kilometres. The town is about 870 kilometres from Bangui, the capital. A small hydro-power plant on the left bank of the Gboyo, owned by the Catholic Diocese of Bangassou, generates electricity 305 days a year and powers the mission and its hospital. There is an airstrip at Bakouma close to the site of the never-realised mine, though when UraMin arrived with heavy machinery in July 2006, the Antonov freighter had to land at Bangassou instead because of runway length. The Catholic Diocese of Bangassou has upgraded 19 bridges between Bakouma and Nzako. These modest improvements - a bridge, a hydro plant, a hospital - were delivered by a church, not by the extractive industries that arrived with bigger promises and left without fulfilling them.