It is a mix of small town, light local industry (including a Tokyo hydroelectric plant) and expensive bedroom community. Most of its people are concentrated in the river valley through which the Chuo main line and expressway run. The river gorge is very scenic, but the primary attractions are the mountains which form the majority of Otsuki-shi. Shopkeepers have some English, but the vast majority of the signage and conversation is in Japanese.
There is a city bus system and taxis available. The bus garage is right across the street from Otsuki Station. Usually there are many taxis waiting in front of Otsuki Station.