The largest settlement within the locality is the village of Karuah, which is on the old Pacific Highway and straddles the Karuah River. Most of the village, which occupies only about of the suburb's total area of , lies within the Port Stephens LGA. It includes the largest Aboriginal community in the Port Stephens LGA and, at the 2006 Census, had a population of approximately 857. The rest of the suburb's population live in the rural properties which surround the village.