Part of the Mongol empire from the 13th century onwards, Altai was annexed by Russia in the 18th century. Its first smelting plant was built in 1726, but its agricultural colonization dates from the 19th century. World War II, when a number of Volga Germans were deported here, and the ‘Virgin Land’ campaign of the 1950s - a huge programme to irrigate the steppe region - gave new impetus to its economic development. The USSR exploded its first atomic bomb in 1949 at a test site in Siberia 170 km/106 mi from the region. The 2.3 million inhabitants were unaware of the test and within two hours were engulfed by the radiation cloud. Research in 1995 (no longer restricted by official secrecy) estimated that 27 of the 58 districts were extensively contaminated with fallout, and approximately 11,000 extra cancers resulted.

Children in the Altai are often born with jaundice; according to aid workers, the incidence in 1997 was over 50% in some villages. This may be due to toxins in rocket fuel, as, according to estimates by space scientists, approximately 1,400 t of rocket fuel had fallen over the Altai region.