A snowmobile trail connects the Tununak and Nightmute in the winter. These three communities comprise the entire population of the island at 1,065 inhabitants as of the 2000 census. The largest community is Toksook Bay. The rest of the island, over 77 percent of its area, is unpopulated.
The village of Newtok, on the mainland across the Ningaluk River north of the island, is in the process of being moved to Nelson Island, due to erosion of the water table in the area where Newtok is currently located.
The natives are Yupiit, who maintain a predominantly traditional diet, fishing and hunting musk ox and caribou.
Nelson Island reported on the 1930 and 1940 U.S. Censuses as an unincorporated area (which included 5 villages on the 1940 census, including Nevortolemute, Nigtmuit (Nightmute), Pngortalick, Tanunak (Tununak), and Ukak.[3] It has not reported as a separate entity since.