Jesuit missionaries first arrived in 1579 and evangelized Agusan and Karaga with much difficulty and intermittent success. To preserve the eastern coast of Mindanao, Spain created another province, the Distrito de Caraga in 1622 with the capital at Tandag. This was an ecclesiastical–military subdivision where authorities exercised sacerdotal and government powers. They collected tribute, organized local defense, regulated production systems, imposed social control. By 1631, mission stations were established in Tago, Siargao, Bacuag and Gigaquit.

In 1750, Distrito de Caraga was composed of 24 pueblos, including pueblos of Butuan, and those that now belong to Surigao del Sur, eight of these belong to the  current provincial territory, namely the Pueblos of Caolo (at Numancia), Cabantog, Sapao, Higaquet, Panhutongan, Surigao, Dinagat and Mainit.

  Pueblo de Surigao became capital of Caraga in 1751 when the Fort of Tandag collapsed. By 1855, the Distrito de Caraga was already reconstituted as Distrito de Surigao.

In 1860, six military districts were established in Mindanao. Surigao and Agusan including the territory lying between Butuan and Caraga Bays, formed the third District called the East District which was later changed in 1859 to “Provincia de Surigao”. Other districts created were Distritos of Zamboanga, Cagayan de Misamis, Davao, the Central District, and Basilan.

However, the East District was converted into the Province of Surigao, under Act No. 127 of the Philippine Commission dated May 15, 1901.

In 1911, Agusan became a separate province. On June 19,1960 through Republic Act 2786, Surigao was divided into two provinces, Surigao del Norte and Surigao del Sur.

In 2006, Dinagat Island became a separate province. The present Province of Surigao del Norte has Only 20 municipalities and 1 component city.