[3] The town was an important religious site during the Middle Ages, drawing devotion from the local rural village communities.

In the mid-13th century, the settlement to the north of Karak Nuh, Bḥaouchiyya, was inhabited by Tanukhid emirs from Mount Lebanon who practiced the Shia faith.

Damascene historian Shams al-Din ibn Tulun (1475–1546), who visited the town noted that "its people were famous for their Shia faith".

[6] The town was largely devastated in strife between the Yunus Harfush and Fakhreddine in 1623 and as a result was abandoned for several decades,[7] with many of its inhabitants moving to Jabal Amel.

[10][13] A Roman inscription in Latin dating to the year 84 CE was found in the basement of a house to the south west of the tomb that called for the long life of the "man with many names".