Vesuvius was formed as a result of the collision of two tectonic plates, the African and the Eurasian. The former was pushed beneath the latter, becoming pushed deeper into the Earth. The crust material became heated until it melted, forming magma, one kind of liquid rock. Because magma is less dense than the solid rock around it, it became pushed upward, finding a weak place at the Earth's surface. It broke through, forming the volcano.

Estimates of the population of Pompeii range from 10,000 to 20,000, whilst Herculaneum is thought to have had a population of about 5,000. It is not known how many people the eruption killed, although around 1,150 remains of bodies have been recovered, or casts made of their impressions in the ash deposits in and around Pompeii. The remains of about 350 bodies have been found at Herculaneum (300 in arched vaults discovered in 1980). However these figures must represent a great underestimate of the total number of deaths over the region affected by the eruption.

38% of the victims at Pompeii were found in the ash fall deposits; the majority inside buildings. These are thought to have been killed mainly by roof collapses, with the smaller number of victims found outside of buildings probably being killed by falling roof slates or by larger rocks thrown out by the volcano. This differs from modern experience, since over the last four hundred years only around 4% of victims have been killed by ash falls during explosive eruptions. The remaining 62% of remains found at Pompeii were in the pyroclastic surge deposits, and thus were probably killed by them – probably from a combination of suffocation through ash inhalation and blast and debris thrown around. In contrast to the victims found at Herculaneum, examination of cloth, frescoes and skeletons show that it is unlikely that high temperatures were a significant cause.

Herculaneum, which was much closer to the crater, was saved from tephra falls by the wind direction, but was buried under 23 m (75 ft) of material deposited by pyroclastic surges. It is likely that most, or all, of the victims in this town were killed by the surges, particularly given evidence of high temperatures found on the skeletons of the victims found in the arched vaults, and the existence of carbonised wood in many of the buildings.

Pompeii and Herculaneum were never rebuilt, although surviving townspeople and probably looters did undertake extensive salvage work after the destructions.
The eruption changed the course of the River Sarno and raised the sea beach, so that Pompeii was now neither on the river nor adjacent to the coast.

The towns' locations were eventually forgotten until their accidental rediscovery in the 18th century. Vesuvius itself underwent major changes — its slopes were denuded of vegetation and its summit had changed considerably due to the force of the eruption.

Large plinian eruptions which emit magma in quantities of about 1 km³ or more, the most recent of which overwhelmed Pompeii, have happened after periods of inactivity of a few thousand years. Sub-plinian eruptions producing about 0.1 km³, such as those of 472 and 1631, have been more frequent with a few hundred years between them. Following the 1631 eruption until 1944 every few years saw a comparatively small eruption which emitted 0.001-0.01 km³ of magma. It seems that for Vesuvius the amount of magma expelled in an eruption increases very roughly linearly with the interval since the previous one, and at a rate of around 0.001 km³ for each year. This gives an extremely approximate figure of 0.06 km³ for an eruption after 60 years of inactivity•.

Magma sitting in an underground chamber for many years will start to see higher melting point constituents such as olivine crystallising out. The effect is to increase the concentration of dissolved gases (mostly steam and carbon dioxide) in the remaining liquid magma, making the subsequent eruption more violent•. As gas-rich magma approaches the surface during an eruption, the huge drop in pressure caused by the reduction in weight of the overlaying rock (which drops to zero at the surface) causes the gases to come out of solution, the volume of gas increasing explosively from nothing to perhaps many times that of the accompanying magma. Additionally, the removal of the lower melting point material will raise the concentration of felsic components such as silicates potentially making the magma more viscous, adding to the explosive nature of the eruption.

The emergency plan for an eruption therefore assumes that the worst case will be an eruption of similar size and type to the 1631 one (which was VEI 4). In this scenario the slopes of the mountain, extending out to about 7 kilometres (4.3 miles) from the vent, may be exposed to pyroclastic flows sweeping down them, whilst much of the surrounding area could suffer from tephra falls. Because of prevailing winds, towns to the south and east of the volcano are most at risk from this, and it is assumed that tephra accumulation exceeding 100 kg/m² – at which point people are at risk from collapsing roofs – may extend out as far as Avellino to the east or Salerno to the south east. Towards Naples, to the north west, this tephra fall hazard is assumed to barely extend past the slopes of the volcano•. The specific areas actually affected by the ash cloud will depend upon
the particular circumstances surrounding the eruption .

The plan assumes between 20 days and two weeks notice of an eruption and foresees the emergency evacuation of 600,000 people, almost entirely comprising all those living in the zona rossa ("red zone"), i.e. at greatest risk from pyroclastic flows. The evacuation, by
trains, ferries, cars and buses is planned to take about seven days, and the evacuees will mostly be sent to other parts of the country rather than to safe areas in the local Campania region, and may have to stay away for several months. However the dilemma that would face those implementing the plan is when to start this massive evacuation, since if it is left too late then many people could be killed, whilst if it is started too early then the precursors of the eruption may turn out to have been a false alarm. In 1984, 40,000 people were evacuated from the Campi Flegrei area, another volcanic complex near Naples, but no eruption occurred .

Ongoing efforts are being made to reduce the population living in the red zone, by demolishing illegally constructed buildings, establishing a national park around the upper flanks of the volcano to prevent the erection of further buildings and by offering financial incentives to people for moving away. The underlying goal is to reduce the time needed to evacuate the area, over the next 20 or 30 years, to two or three days.

The volcano is closely monitored by the Osservatorio Vesuvio in Naples with extensive networks of seismic and gravimetric stations, a combination of a GPS-based geodic array and satellite-based synthetic aperture radar to measure ground movement, and by local surveys and chemical analyses of gases emitted from fumaroles. All of this is intended to track magma rising underneath the volcano. So far, no magma has been detected within 10 km of the surface, and so the volcano was, in 2001, at worst only in the very early stages of preparing for an eruption•. This status has apparently not changed much to date .

The area around Vesuvius was officially declared a national park on 5 June 1995. The summit of Vesuvius is open to visitors and there is a small network of paths around the mountain that are maintained by the park authorities on weekends.

There is access by road to within 200 metres of the summit (measured vertically), but thereafter access is on foot only. There is a spiral walkway around the mountain from the road to the crater.

You can also look around parts of Herculaneum and Pompeii which have been uncovered.