Sai was intermittently occupied by the Egyptians during the New Kingdom. In the Makurian period it was the center of a bishopric, while in the second half of the 16th century the Ottomans founded a fortress on the island. The northeast portion of the island contains a New Kingdom of Egypt temple and numerous mills associated with ancient gold production.
Nearby is an Ottoman Empire fort composed of sandstone quarried along the river banks, and spolia bearing the cartouche of Amenhotep IV, amongst other 18th Dynasty rulers. Numerous round tombs are close by