San Ignacio and Santa Elena are towns in western Belize. San Ignacio serves as the cultural-economic hub of Cayo District. It got its start from mahogany and chicle production during British colonisation. Over time it attracted people from the surrounding areas, which led to the diverse population of the town today. San Ignacio is the largest settlement in Cayo District and the second largest in the country, after Belize City.

The Macal River is a river running through Cayo District in western Belize. Sites along the river include the ancient Mayan town of Cahal Pech and the Belize Botanic Gardens. The Macal River discharges into the Belize River. There are several tributaries to the Macal River including the following streams: Privassion, Rio On, Rio Frio, Mollejon and Cacao Camp.