The natural landscape of the Prešov region is very varied with most of this second largest region in Slovakia being hilly in character. The region is bisected by an important boundary between the Western and Eastern Carpathians. Of the many mountains and hills in the region, we should mention the Tatras, Pieniny, Spišská Magura, the Levočské hills, Čergov, the Šariš uplands, the Košice basin, the Slanské hills, the Ondavská uplands, the Laborecká uplands, the Bukovské hills and the Vihorlat hills.
In terms of its natural landscape the Prešov region is one of the most precious in Slovakia.
The region is home to the oldest national park in Slovakia (1949) the Tatran National Park (TANAP), which since 1993 has also been a biospheric reservation, as well as Pieniny National Park (PIENAP), the oldest international natural park in Europe, and Poloniny National Park, the primeval forests of which are a UNESCO World Heritage Site. Land covered by two other parks, the Low Tatras National Park (NAPANT) and the Slovak Paradise National Park, with its distinctive landscape of canyons and gullies, also extends into the Prešov region. The Eastern Carpathian Protected Landscape Area is richly forested while the Vihorlat Protected Landscape Area is rich in plant and animal species. As well as a number of extensive protected areas in the Prešov region, there are also dozens of much smaller protected areas here: national natural reservations, national reservations, national natural monuments, natural monuments and protected areas.
The highest point in the Prešov region is the peak of Gerlach (2655m) in the High Tatras, which is also the highest point in the whole country. The lowest is at the point where the River Ondava flows out of the region in the village of Nižný Hrušov (105m).
The Prešov region has the coolest and rainiest climate in Slovakia. From the hydrological point of view, the region is divided between the Baltic and the Black Sea drainage basins with the main European watershed crossing the region. The major rivers in the region are the Torysa, the Topľa, the Ondava, the Laborec, the Cirocha, and in the western part of the region, the Poprad and the Dunajec. Most of the natural lakes or tarns in the region are in the High Tatras, the largest and deepest of which is Veľké Hincovo tarn (20.08 ha, 53 m), the highest of which is Modré pleso (Blue Tarn) at 2192m above sea level. The highest waterfall in Slovakia is the Kmeťov waterfall which rises 80m above the Nefcerka valley.
The dam lake at Veľká Domaša on the Ondava and the Starina reservoir on the Cirocha are both impressive while the most famous mineral springs in the region are the acidulous waters of Vyšné Ružbachy, Nová Ľubovňa, Bardejovské Kúpeľe, Cigeľka, Sivá Brada, Baldovce, Gánovce, Lipovce and Šindliar. For many years Bardejovské Kúpeľe, Vyšné Ružbachy and Nová Ľubovňa have also been attractive spa resorts.
The original vegetation of the region was predominantly made up of forest species, with oak, beech, spruce, larch, fir and pine trees the most common. The fauna of the region is also very interesting with the occurrence of such wild animals as the brown bear, the common wolf, the northern lynx, the central European chamois, or mountain goat, and the Tatran marmot, as well as various other animal species typical for the region.