The county has a population of 42,369 people as of the 2020 census. Okanogan, with a population of 2552, is the second largest city in the county, and the county seat. Omak, the largest city in the county has a population of 4,752. Other cities within the county are: Brewster (2,370), Conconully (193), Coulee Dam (1,074), Elmer City (250), Nespelem (240), Oroville (1,921), Pateros (714), Riverside (271), Tonasket (1,015), Twisp (991), and Winthrop (419). The county has an unincorporated population of 27, 404, while the incorporated population is 14,965, with a density of 8 persons per square mile.
Agriculture and forestry are the major economic generators for the county and are the foundation for the region, which employs approximately 5,756 people. Government, retail trade, services, and manufacturing are a few of the major employers within the county. Omak, the regional center for services and trade, is experiencing a great deal of growth. There is also increasing commercial development pressure in the area between the Canadian border and Oroville. The City of Coulee Dam is the location of Grand Coulee Dam, one of the largest concrete structures in the world, and largest electricity producer in the United States. The Dam also has a visitors center with guided tours, background movies, and extensive information of the region. The Methow Valley, located in the western portion of the county, is quickly becoming a destination for outdoor lovers and enthusiasts and includes hundreds of square miles of cross-country ski trails, snowmobile parks, mountain biking, fishing, camping, hiking, and offers many tourist accommodations and weekend get-a-ways, and a possible four seasons destination resort.