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From Antsohihy travellers can continue their journey in all points of the compass: [[Ambanja]] to the north (217km paved road in good condition), [[Antananarivo]] to the southwest, [[Bealanana]] to the northeast, [[Befandriana]] to the southeast and [[Analalava]] to the west (79km paved road).
Antsohihy is connected inland with the Loza
river that joins a waterway some 50km leading to the ocean, past various villages and finally Ananalava at the mouth of the river, an isolated coastal village which during wet periods is only accessible by boat or light plane. The river port is located about two kilometres from the Antsohihy town centre and the trip takes about half a day.
The people of Antsohihy live from forestry, trade and transport activities. Collection of seafood (mud crabs, sea cucumbers, shrimp) from Analalava and Bay Narinda. In 2005, the town of Antsohihy had about 20,000 inhabitants.