Midi-Pyrénées has no historical or geographical unity. It is one of the regions of France created artificially in the late 20th century to serve as a hinterland and zone of influence for its capital, Toulouse, one of a handful of so-called "balancing metropolises" (métropoles d'équilibre). Another example of this is the region of Rhône-Alpes which was created as the region for Lyon.

The name chosen for the new region was decided by the French central government without reference to the historical provinces (too many of them inside the region) and based purely on geography: Midi (i.e. "southern regions") - Pyrénées (Pyrénées mountains that are the southern limit of the region). The French adjective and name of the inhabitants of the region is: Midi-Pyrénéen.

Major communities include:

• Albi
• Auch
• Blagnac
• Cahors
• Castres
• Colomiers
• Lourdes
• Millau
• Montauban
• Muret
• Rodez
• Tarbes
• Toulouse
• Tournefeuille