The village is located in the Bormida high valley, with the urban settlement located along the right bank of the Bormida River, which in this section assumes the denomination of Bormida of Millesimo. The territory is part of the Bric Tana Regional Nature Park.
In Millesimo there a site of Community interest, which has been preserved and proposed by the Natura 2000 network of Liguria, for its natural, faunistic and geological interest. The site is located in the wooded area of Bric Tana and Bric Mongarda where there are caves where prehistoric evidence has been found.
