Most of the peoples whose languages are grouped together under the catchall category of Paleo-Siberian live in northeasternmost Siberia in the area between the East Siberian Sea and the Sea of Okhotsk, including the Kamchatka Peninsula, along the coast of the Sea of Okhotsk as far south as the Amur River, and on Sakhalin Island; peoples of another Paleo-Siberian group live far to the west along the middle and upper Yenisey River. The Paleo-Siberian languages form three groups that are not only not related to each other but also have not been demonstrated to be related to any other genetic groups. (Another group sometimes classified as Paleo-Siberian, the Yukaghir, is now considered by some linguists to be a member of the Uralic language family, perhaps an offshoot of Early Uralic.)

The northernmost and most widespread of these linguistic groups and the only one that includes more than one living language is the Luorawetlan family, which consists of Chukchi, Itelmen (Kamchadal), and Koryak. Most scholars now classify Kerek and Aliutor, once considered to be dialects of Koryak, as independent languages. (see also Index: Luorawetlan languages)

Nivkh (Gilyak), spoken on Sakhalin Island and in the coastal and inland Amur River country of the mainland, has no known linguistic relatives. Ket (or Yenisey-Ostyak) is the only language of the Yeniseian or Yenisey-Ostyak family that is still spoken. Ket speakers live along the upper and middle Yenisey River, as did the speakers of its sister languages, Kott (Cottian-Manu), which became extinct in the 19th century, and Assan (Asan) and Arin, both of which became extinct in the 18th century (see Paleo-Siberian languages). (see also Index: Nivkh language, Ket language, Arin language)