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The city lies only 10 kilometres from the Thai border. Koh Kong has long had a reputation as a "wild west" frontier town. In this relative isolation, illegal logging , wild animal smuggling, banditry, gambling, prostitution, and a soaring rate of HIV AIDS infection  have given Koh Kong its frontier town reputation.
However, with the building of the Thai-Cambodian bridge across the river and the upgrading of the road to the national highway, industry and investment have increased and the town is becoming a modest tourist destination. Koh Kong town is accessible by land, sea, and air. From the border it is 10 kilometres to the town. The road crosses four large rivers where bridges have recently been built. Until the end of the s, Koh Kong was one of the least secure parts of the country.
Elements of the Khmer Rouge based in the lower Cardamoms still posed a serious threat to locals and travellers. The area was the scene of intermittent fighting between the government and Democratic Kampuchea forces until They claimed via Khmer Rouge Radio to have killed 1, Vietnamese troops and injured more during the battle. Khmer Rouge Radio reported that they had killed 28 Vietnamese soldiers and injured 34 others.
As late as , the Khmer Rouge were still active in the area. In November of that year, one of the last recorded incidents before the surrender of the remaining Khmer Rouge forces to the government occurred near the international border crossing outside of Koh Kong city.
One Thai gambler was injured in the attack which involved rocket-propelled grenades, mortars and conventional rifles. The Trat police chief later stated that the attack was prompted by the casino failing to make a protection payment to the rebel group. Koh Kong town is just below the southern end of the Cardamom Mountains.