The state runs from the Egyptian border in the north to Eritrea in the southeast, bordered inland by River Nile State and Kassala State. About 1.48 million people live in it, more than half in urban centers, overwhelmingly Port Sudan. The terrain is a narrow coastal plain rising fast to the Red Sea Hills, part of the Red Sea rift system, running parallel to the coast in a north-south line of Precambrian gneiss and granite. Between them run khors, seasonal watercourses that race eastward toward the sea after the rare rains. Sudan also claims the Halaib Triangle on the far northern frontier, which Egypt administers. The dispute has simmered since the 1990s and has never been resolved.

Before Port Sudan, there was Suakin. From the 15th to the 20th century, Suakin was the principal African port on the Hajj route to Mecca, its coral-block buildings lined along a natural coral harbor. Beja groups and coastal traders ran the town's economic life jointly for centuries. It passed under Ottoman administration in the 16th century and cycled through waves of imperial attention, and in the late 19th century it was fortified during the Mahdist wars. Then the Suez Canal opened, ships grew deeper keels, and the coral-choked harbor that had made Suakin work made it obsolete. Port Sudan replaced it between 1905 and 1909. The old town's coral walls are still there, half ruined, half maintained, a monument to a trade pattern that ended within living memory.

Human presence along this littoral goes back to the Middle Paleolithic. The Eastern Desert has yielded Neolithic sites and, later, Pharaonic-era inscriptions connecting the Nile Valley to the Red Sea. The Tokar Delta, south of Port Sudan, is one of the reasons people kept coming. Seasonal floods from the Baraka River deposit silt every year, enough that local farmers barely need to add fertilizer. Cotton grew here for decades, when it could find water. Sorghum, millet, and vegetables still do. The smaller Arbaat Delta to the north of Port Sudan offers similar conditions on a reduced scale. Between the deltas and the hill foothills, most of the state is arid or semi-arid, with rainfall highly variable and vegetation that appears after good rains and retreats to isolated patches when they fail.

The Red Sea Hills are Beja country. The Ababda, Amarar, Bishariin, and Hadendoa are the major subgroups, all Cushitic pastoralists who have lived along this coast since antiquity. They speak Bidhaawyeet, with regional varieties that shift with geography. The Ababda and Rashaida speak Arabic. The Beni Amer speak Tigre. In urban Port Sudan, Sudanese Arabs and Nuba people are well represented, concentrated in the city while pastoralists continue to move across the hills with their herds. Beja politics took an organized turn in the 1990s and 2000s, when elements of the community joined the Rashaida Free Lions to form the Eastern Front, waging a low-intensity insurgency against the central government over resource sharing. The Asmara-brokered Eastern Sudan Peace Agreement of October 14, 2006, was supposed to resolve the grievances through integration, political representation, and development funds. Implementation was incomplete, and complaints continued for years.

On April 15, 2023, fighting broke out in Khartoum between the Sudanese Armed Forces and the Rapid Support Forces. Within months, Port Sudan had become the de facto administrative center and a refuge for hundreds of thousands of people who had fled the capital. Red Sea State, which had been Sudan's economic gateway, became Sudan's emergency government. The national institutions that could move, moved here. The displaced arrived with what they could carry, in heat and with limited water. The port and its infrastructure were repeatedly targeted by drone and air strikes through 2024 and into 2025, with fuel depots, power facilities, and container yards damaged, disrupting the maritime and humanitarian logistics the whole region depended on. A state that had spent a century as Sudan's trade corridor was now its front line.

Red Sea State has mineralized zones in the hills, including gold-bearing dikes that have been mined since antiquity. Pastoralism is still the dominant way of life outside the delta and the port. Herders move seasonally, diversify their stock, and navigate dry years with the knowledge built over generations of living between the hills and the sea. Satellite imagery of the vegetation index shows what locals have always known: good rains make a brief green world, and dry years turn most of the interior back into a collection of ephemeral patches along the khors. The Red Sea itself, offshore, is one of the world's richest coral ecosystems, and divers who can reach the Sudanese reefs describe them as some of the least-disturbed on Earth. That is a reflection of both the beauty of the coast and the hardship of reaching it.