There are three different historical regions: the abbey and the city of Prüm have been directly subordinate to the Holy Roman Emperor in medieval times; later the free city became the principality of Prüm, occupying large portions in the north.
The eastern parts of the district, including the town of Kyllburg, were property of the bishop of Trier.
When Prussia gained all these regions about 1815, it established the three districts of Bitburg, Prüm and Trier. In 1970 the districts of Bitburg and Prüm were merged with parts of the former district of Trier in order to form the present district.
On January 1 2007 the full name of the district was changed to be Eifelkreis Bitburg-Prüm instead of Landkreis.
The district covers the sparsely populated southwestern part of the Eifel Mountains. The portions along the western borders are occupied by a common German-Belgian nature park and a German-Luxembourgian nature park. A great number of rivers rise from the Schneifel in the northwest and from the Kyllwald in the east, and runs southward to the Sauer River (French Sûre), which is an affluent of the Moselle.