Minamiuonuma city is situated in a valley in a mountainous region of Niigata Prefecture known as "Snow Country" because of the heavy snowfall in winter. The city is bounded by Uonuma city and the Echigo-Sanzan mountains in the north, and Yuzawa, a popular ski resort town, in the south. The Uono river flows through most of the city. The city and its surrounding areas are dotted with many onsen (Japanese hot springs) and 8 ski resorts, making it a popular destination in winter. There are also a large number of paddy fields, as this is a major rice-growing region in Japan.

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