According to custom, Middle Tennessee consists of that portion of the state east of the Tennessee River's western crossing of the state (in which it flows northward back into Tennessee after having flowed through northern Alabama) and west of the dividing line between the Eastern and Central time zones. Exceptions to this rule are that Hardin County, which is located on both sides of the Tennessee River, is considered to be entirely in West Tennessee and that Bledsoe, Cumberland, Marion and Sequatchie counties are generally considered to be in East Tennessee despite being in the Central Time Zone. Also, the current legal definition places Sequatchie County in the middle grand division instead of the eastern division.

Middle Tennessee is known for its rolling hills and fertile stream valleys, as well as for its major city, Nashville, which is the state capital. Other major sizeable cities in Middle Tennessee include Clarksville and Murfreesboro. Politically, it has provided the Democratic Party with some of its leading statesmen, and still is largely inclined toward it, although an increasing Republican trend has been seen in the Nashville suburbs. Geographically it is composed predominantly of the Nashville Basin and the Highland Rim, although the western portion of the Cumberland Plateau also extends into Middle Tennessee.

Middle Tennessee also has an abundance of institutions of higher learning--most notably Vanderbilt, Belmont, Lipscomb and Tennessee State universities in Nashville and Tennessee Tech University in Cookeville. Other prominent universities are Austin Peay State University in Clarksville, the University of the South in Sewanee, Cumberland University in Lebanon, and Middle Tennessee State University in Murfreesboro, which is the state's second largest institution of higher learning, just behind the University of Tennessee in Knoxville.

Unlike the geographic designations of regions of most U.S. states, the term Middle Tennessee has legal as well as socioeconomic meaning. Middle Tennessee, West Tennessee and East Tennessee comprise the state's three Grand Divisions. According to the Tennessee State Constitution, no more than two of the state supreme court's five justices can come from any one Grand Division. A similar rule applies to certain other commissions and boards as well, to prevent them from showing a geographic bias.

Middle Tennessee is the largest in area and least densely populated of the three Grand Divisions. At the 2000 census it had 2,069,976 inhabitants living in its 40 counties, which have a combined land area of 44,054.17 km² (17,009.41 sq mi). Its population was 36.38 percent of the state's total, and its land area is 41.27 percent of the state's land area. Its population density was 46.987/km² (121.696/sq mi) at the census.

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