It was originally formed by the United States Census Bureau in 1950 and consisted solely of Fayette County until 1980, when surrounding counties saw increases in their population densities and the number of their residents employed within Lexington-Fayette, which led to them meeting Census criteria to be added to the MSA.

The Lexington-Fayette MSA is the primary MSA of the Lexington-Fayette–Richmond–Frankfort, KY combined statistical area which includes the Micropolitan Statistical Areas of Frankfort (Franklin and Anderson counties), Mount Sterling (Montgomery, Bath, and Menifee counties), and Richmond–Berea (Madison and Rockcastle counties).

The Lexington-Fayette–Frankfort–Richmond, KY combined statistical area has a July 1, 2012 Census Bureau estimated population of 703,271.

[3] The following is a list of cities in the Lexington-Fayette metropolitan area with 2021 United States Census Bureau estimates of their population.

[4] Principal cities of the metropolitan area are considered by the Census Bureau to represent significant employment centers:[5] Principal city Municipalities with more than 10,000 people Municipalities with fewer than 10,000 people • Populations are based on published estimates by the United States Bureau of the Census.