[2] Hillsboro was named for pioneer John (Richard) Hill, from North Carolina, who built a log cabin near what is now Lobelia.

The basement of the Methodist Church served as a school of high order for girls called Hillsboro College, or Little Levels Seminary.

[5][6] Millpoint, in northern Hillsboro, was once the site of a small industrial village, "including within its limits proper a store, a blacksmith shop, two flour mills, and three homes.

In 1892, the author Pearl S. Buck was born in a large white two-story house at the northern end of town.

Shortly thereafter, her family, Presbyterian missionaries, returned to China, but her West Virginia roots nevertheless had a significant impact on Buck through her mother Carrie.

[8] The Dutch-style "city house," now on the National Register of Historic Places, has been restored into a museum, the Pearl S. Buck Birthplace.

Also on the National Register of Historic Places are the Richard Beard House and Locust Creek Covered Bridge.

[9] In late June, the town hosts the annual Little Levels Heritage Fair[10] to celebrate the history of the region.

[12] According to the United States Census Bureau, the town has a total area of 0.36 square miles (0.93 km2), all land.