By 2151, the Akaali population was around 500 million, living in dozens of cities on all continents with as many languages. They travelled their oceans by clipper ships and lighted their cities with residic oillamps. In a city visited by an Enterpriseaway team all inhabitants were required to carry identification papers. Despite their relatively primitive technological level, T'Pol and Phlox both expressed admiration for the forensic work of an apothecary.
Another race, known as the Malurians, were clandestinely exploiting their planet for veridium. The use of tetracyanate 622 in this process caused many Akaali to suffer from a serious disease, causing lesions on their faces, before the Malurians were driven off the planet by Enterprise. (ENT: "Civilization")
The script of "Civilization" describes the Akaali as "humanoids with small ridges on their faces, and minor skin colorations." Also, another scene description in that script refers to the Akaali as the first civilization encountered by Enterprise. In a scene that was scripted for the end of ENT: "Home" (and included in the ENT Season 4 Blu-ray) but never filmed, the Akaali are similarly said to have been the first pre-warp civilization discovered by Enterprise. They were intended to be referred to as such by Captain Archer.