Ngườm Slưa cave developed within a limestone massif formed under shallow, warm marine conditions approximately 270-360 million years ago (Carboniferous-Permian period). In front of the cave, traces of two river terraces remain – evidence of recent uplift activity in the area (known as neotectonic activity).

According to the legend of the Tay people, Ngườm Bốc is where the young couple Pú Lương and Slao Cải met and became husband and wife, while Ngườm Slưa is the cave where Pú Lương fought a tiger to protect the peaceful life of his family.

Ngườm Slưa was the printing location of the Cờ Đỏ (Red Flag) newspaper (1932-1933), and a base for revolutionary activities from 1932 to 1936. Here, the Cao Bằng Party Committee held the Indochina Congress in May 1936 to mobilize the people of the province to support the "Indochina Congress" movement and drafted the "People's Petition" demanding democratic reforms, improved living conditions, and open and legal struggle.

Ngườm Slưa was classified as a National Historical Monument according to Decision No. 188 VH/QD/BT dated February 13, 1995.