Historically, the term Lothian is used for a province encompassing the present area plus the Scottish Borders region. The name is related to the legendary British King Loth or Lot. In the 7th century it became the northern part of the Saxon Kingdom of Northumbria.

The Local Government (Scotland) Act 1973 abolished the counties and burghs as local government units, replacing them with Regions and Districts. Lothian Regional Council formally took over responsibility in May 1975.

The Region was responsible for education, social work, water, sewerage, transport (including local buses within Edinburgh). Certain services provided by joint boards with neighbouring Borders Regional Council - notably for Lothian & Borders Police and the Lothian & Borders Fire Brigade. These joint authorities continue.

The two-tier system of local government was criticised by some as providing needless duplication. Lothian Regional Council was abolished in 1994, replaced by a unitary system of local government. The former District Council areas of West Lothian, City of Edinburgh, Midlothian and East Lothian were used as the basis for the new Councils. The last convener of Lothian Regional Council was Eric Milligan, who later served as Lord Provost of Edinburgh. Lothian Regional Council also organised a series of lectures known as the Lothian Lectures, a notable speaker was Mikhail Gorbachev.

In the post-Roman period, Lothian was dominated by Brythonic speakers whose language was akin to Welsh and Cornish and came to be part of Hen Ogledd. Remnants can be found in placenames such as Lothian, Tranent, Linlithgow and Penicuik.

Lothian is notable in Scotland for being the only part of the nation to have been mainly Anglo-Saxon throughout the history of the Kingdom of Scotland and was described by Adam of Dryburgh as "The land of the English in the Kingdom of the Scots".