The disclosure is directed to techniques for content-adaptive background skipping for region-of-interest (ROI) video coding. The techniques may be useful in video telephony (VT) applications such as video streaming and videoconferencing, and especially useful in low bit-rate wireless communication applications, such as mobile VT. The disclosed techniques analyze content information of a video frame to dynamically determine whether to skip a non-ROI area within the frame. For example, the skipping determination may be based on content activity, such as ROI shape deformation, ROI motion, non-ROI motion, non-ROI texture complexity, and accumulated distortion due to non-ROI skipping. The skip determination may operate in conjunction with either frame-level or macroblock-level bit allocation.