A recent survey in the western foothills of the Zagros Mountains has located five new Neolithic sites. We present here the occupational features and finds of this period in the Sar Pol-e Zahāb region, along with an interpretation of their distribution and associated settlement patterns. Our research indicates that the visible distribution of Neolithic sites is highly influenced by geomorphological factors. All sites are located on natural outcrops or on the edge of alluvial plains. Many others have certainly been buried beneath layers of later sedimentation. All of the sites identified by our survey are small and of modest elevation, with cultural remains, particularly ceramics, similar to Neolithic sites such as Guran and Sarāb in the central Zagros region and Jarmo and Tamarkhan in Mesopotamia. Based on the ceramic evidence and the location of the region, between the central Zagros mountains on the east and Mesopotamia on the west, we suggest that this vast area maintained an integrated ceramic tradition, which suggests an overall cultural homogeneity of these areas during the seventh and early sixth millennia B.C. In other words, these recent discoveries indicate that similarities in Neolithic material culture in the Māhidasht, Kermanshāh and Hulailan plains with material culture of regions in Mesopotamia are not accidental or random but indicative of a large coherent zone with unique ceramic and cultural traditions (the patterned ceramic tradition of Sarāb-Jarmo), extending from Iraqi Kurdistan east into the central Zagros range. Regarding the lack of eighth and seventh millennium B.C. sites in the northern reaches of the Iranian part of the Zagros range, we may consider the pathway of Sar Pol-e Zahāb a primary route for transporting obsidian to upland areas of the central Zagros. This also suggests a lasting network of cross-regional communications, since archaeological discoveries prove this pathway was the main node connecting these two cultural regions for a long period of time.