Now, though, a growing number of foreign tourists are heading to the breakaway territory -- which is not recognised by any state -- and say they are seeing a different side to its war-scarred image.
Wandering around the region's largest town Stepanakert as part of a tour group whose members come from places ranging from Turin to Taiwan, French pharmacist Jordan Nahoum said that while he knew all about Nagorny Karabakh's bloody past, he was surprised by what he found.
"People are very nice and open," Nahoum, 23, told AFP as he stood next to a row of hawkers selling tourist trinkets. "It is very safe here and I see many tourists from different countries -- I don't feel myself in danger."
Seized from Azerbaijan by Armenian-backed separatists in a brutal war that claimed an estimated 30,000 lives as the Soviet Union disintegrated in the early 1990s, Nagorny Karabakh remains frozen between war and peace.
Despite a fragile 1994 ceasefire that ended major hostilities, repeated attempts to get Armenia and Azerbaijan to sign a final peace deal over the past two decades have failed, and both sides -- especially oil-rich Azerbaijan -- are rearming heavily.
Nagorny Karabakh is still recognised as part of Azerbaijan by the United Nations, but its population is almost completely ethnic Armenian after the Azerbaijani community fled in the wake of the war.
Soldiers along the heavily fortified frontline exchange gunfire almost daily, with both sides blaming each other for violating the ceasefire. So far this year some 20 soldiers from both sides have been killed.
-- 'A pleasant place for tourism' --
Despite this, the local authorities have pumped money into promoting the region at tourist fairs overseas, and they say the drive is paying off.
Over the past few years, local authorities say, visitor numbers have grown by 40 percent annually and in 2012 the number of foreign tourists -- not counting visitors from Armenia's huge diaspora -- topped 15,500 people.
"This unprecedented growth shows that despite the heated confrontation with Azerbaijan we've created an image of Karabakh as a pleasant place for tourism, safe and interesting," says Sergey Shahverdyan, head of the separatist authority's department for tourism.
Once ravaged by fighting, the serene boulevards of Stapanakert -- some 50 kilometres (30 miles) from the frontline -- do not feel like they are in a conflict zone and the town is now studded with new hotels and restaurants following a building boom in recent years.
"If we can maintain this sort of growth in visitors then in five years tourism will be one of the most profitable sectors for our budget," Shahverdyan said, pointing out that no tourist had ever been injured in Karabakh.
-- Rugged mountains and thickly forested hills --
Azerbaijan though is fiercely opposed to the nascent tourist industry in a region it considers under illegal occupation.
Anyone visiting Nagorny Karabakh -- which is only accessible by road from Armenia -- risks being blacklisted by Baku, and moves to open a new airport that would boost Stepanakert's links to the outside world have brought threats of a return to war.
But for those willing to risk the journey, tour operators argue that there is plenty to attract tourists to Nagorny Karabakh -- a spectacular highland area of rugged mountains and thickly forested hills.
Despite the destruction of cultural heritage in the war, the region remains studded with testaments to its rich and diverse history -- from ancient ruins to medieval monasteries and 18th-century mosques.
For some visitors though, that is not enough.
"There are those who prefer extreme tourism, who want to go to the frontline, but we have to explain to them that it can be dangerous as there are minefields," said Gohar Hovannisyan, a manager at tour firm Sati.
In fact, it is impossible to escape the grim reminders of the region's brutal conflict, which often saw neighbour turn on neighbour and the entire 600,000-strong Azerbaijani population of Nagorny Karabakh and seven surrounding districts forced to flee.
"We don't hide anything about the conflict," says tour guide Ani Hovhannisyan.
But both sides have radically different versions of what happened and inevitably it is the Armenian side of the story tourists hear when they visit.
Such is the case with the town of Agdam -- a former Azerbaijani city of around 50,000 inhabitants outside Karabakh, which was one of several areas Karabakh Armenian forces overran in 1993.
It is now a bombed-out ghost town, its Azerbaijani population among the hundreds of thousands forced to flee the region. Hovhannisyan says she tells her tourists that Agdam had to be cleared because Azerbaijanis there used to fire on Armenian civilians.
Despite the region's uncertain future, tourists like Andrey Hoynowski from Poland say they will be recommending a visit to their friends back home and that the added attention might even help Karabakh move on.
"They need to resolve this conflict peacefully, but in the meantime they shouldn't stop tourists from travelling here," Hoynowski, 59, said, smiling for a photograph in front of the medieval Gandzasar monastery.
