As with some of the other districts, Butha Buthe is the capital city of the district of the same name. It is Lesotho’s second largest city, with a bustling town centre, government and other administrative buildings, retail outlets and a number of hotels. It also has one of Lesotho’s larger Mosques as a result of its sizeable Indian community. It is located some 125 kilometres north of Maseru at the beginning of the northern ascent into the Maluti Mountains, and from here the Tsehlanyane National Park is best accessed.

Butha Buthe too has benefited immensely as a result of the Lesotho Highlands Water Project, with a suburb (Likileng) being established to house the large workforce working on the project.