Historically, Narathiwat was the part of the semi-independent Malay Sultanate of Patani, paying tribute to the Thai kingdoms of Sukhothai and Siamese kingdom of Ayuthia. After Ayutthaya fell in 1767, Sultanate of Patani gained full independence, but under King Rama I it again came under Thai control 18 years later and in the early 1800s was divided into 7 smaller kingdoms.
In 1909, Narathiwat was fully integrated into Siam as part of Anglo-Siamese Treaty of 1909 negotiated with the British Empire. Along with Yala, Narathiwat was then part of Monthon Pattani. There is a small but active separatist movement, which after being dormant for many years erupted again in 2004.