Alexander County is part of the Cape Girardeau-Jackson metropolitan area which is made up of jurisdictions on both sides of the Mississippi River.

It was named for William M. Alexander, a physician who practiced in the town of America (the first county seat).

The county was initially developed for agriculture and settled by numerous migrants from the Upland South.

As African Americans settled in Cairo to seek jobs on steamboats, ferries, in shipping and railroads, there were tensions between the racial groups.

They excluded them from the city government and the police and fire departments, and relatively few African Americans were hired to work in the local stores.

[5] The most notorious of these was the lynching of Will James before a crowd of white spectators estimated at 10,000, in the county seat of Cairo on November 11, 1909.

Later that same evening, the mob lynched a white man named Henry Salzner, hanging him in the courthouse square for allegedly killing his wife.

Neither man had had a trial, nor was anyone ever prosecuted for the lynchings, even though Illinois had passed an anti-lynching law four years earlier.

[12] On January 4, 2013, after years of controversy over inmate conditions, the prison officially closed, negatively impacting the county's economy.

[13][14][15] In late September 2009, press reports indicated that the Alexander County Sheriff's office had five of its seven squad cars repossessed as payments had not been made.

[25] Although the population of the county had been decreasing for decades, the closure of the Tamms Correctional Center in 2013 probably caused an acceleration of the decline in the 2010s.

[citation needed] In the twenty-first century, the county has shown a trend towards the GOP due to large-scale black emigration and a rapid swing of its Caucasian population toward Republican candidates.