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The district is one of the farthest from a coastline in New Zealand and one of the few to experience a continental climate with severe winters and hot, dry summers.
At the 2001 census the permanent population was 4,407, a drop of 210 since 1996, and 23.5 per cent of the population (higher than the national average) was aged over 65.
The town was founded during the Central Otago gold rushes in the 1860s.
Alexandra is the service centre for a significant stone-fruit industry, which is celebrated by a blossom festival in the town each spring. Grape production is another major industry in the Central Otago region.
Many orchards were destroyed in the 1980s as a result of construction, 10 km upriver, of the Clyde High Dam, which serves the country's largest hydroelectric power station.
The town is a popular holiday destination.