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The Ushachi region has a rich and colourful history. Archeologists discovered Stone Age’s sites in the local villages of Putilkovichi and Sloveni. There are more than 40 burial mounds in the region. The territory of the modern-day Ushachi region was a crossing point on the way of Polotsk princes to Minsk and the Minsk princes to Polotsk.

In the 9th century the territory of the region became part of the Polotsk Principality and in the 14th century part of the Great Principality of Lithuania.

In 1563, Moscow Tsar Ivan the Terrible occupied Polotsk and burnt it down including the settlement of Orekhovno. Ushachi was first mentioned in chronicles in the 16th century as a village of the Polotsk province. Since 1594, it was the centre of the volost (region). In 1667, the estate of Ushachi included three villages. It had a wharf, a church, a monastery and a tavern. Annually Ushachi hosted two fairs. In 1657, the Basilian monastery was built in Ushachi, in 1761 – a Catholic church and the Monastery of the Preachers with various service facilities, a winery, a hospital and a school were built in Ushachi as well. On June 23, 1758 Ushachi was granted the Magdeburg Right. In 1776 Ushachi became the centre of the Polotsk province.

In 1793, the Ushachi region was incorporated into the Russian Empire. Up to 1805, Ushachi was the centre of the Lepel uezd (region) of the Vitebsk province.

In 1846, the population of the settlement of Ushachi included 95 people. In 1880, a winery, a water mill, 18 stores, 2 Orthodox churches, a Catholic church and 3 Jewish prayer schools were built in Ushachi. A parochial school was set up in the settlement in 1890. In 1897, the population of Ushachi was 1,268 residents. There were 170 houses, a tannery, a water mill, a hospital, a drugstore and 16 shops in Ushachi.

In mid September 1917, the Soviet power was established in the Ushachi volost. In 1918, the region was occupied by German troops. On September 25, this area was occupied by Polish troops. In 1919, the Ushachi volost became part of the Russian Soviet Federative Republic. In March 1923, the Ushachi area becamepart of the Belorussian Soviet Socialist Republic.

The Ushachi region was founded on July 17, 1924.

In 1928, the first health centre “Barkovschina” opened in the region. In November 1930, the region issued its first regional newspaper - Prymezhny Kalgasnik. the Ushachi Flax-Scutching Mill was launched in 1931 and a saw-mill in 1934. In the mid 1930s the Ushachi region had 2 local and 17 rural councils of people’s deputies including 1 Latvian and 2 Jewish councils.
In 1936, Ushachi saw a new hospital and Ushachi Forestry inaugurated.

In 1941, the population of the town of Ushachi was 2,700 residents.

On July 3, 1941, Ushachi was occupied by Nazi troops. Within one year, the Nazis killed about 1200 people in the region including 900 Jews.

In September 1943, the partisan zone of the Ushachi region included 16 brigades (17 thousand partisans).

The territory of the region was liberated from the Nazis on June 29, 1944.

On September 20, 1944, the territory of the Ushachi region was made of the Polotsk oblast and on January 8, 1954 0 the Vitebsk oblast of Belarus. At present the region includes 10 rural councils.