The Bureau of Economic Analysis combines the city of Martinsville with Henry County for statistical purposes.

Martinsville is the principal city of the Martinsville Micropolitan Statistical Area, which includes the communities and towns of Axton, Bassett, Chatmoss, Collinsville, Fieldale, Horsepasture, Laurel Park, Oak Level, Sandy Level, Stanleytown, Villa Heights, Spencer and Ridgeway.

[8] He developed his plantation Scuffle Hill on the banks of the Smith River near the present-day southern city limits.

[9][10] DuPont in 1941 built a large manufacturing plant for producing textile nylon filament, a vital war material.

[13] For several years Martinsville was known as the "Sweatshirt Capital of the World", and in the 1980s it boasted of having more millionaires per capita than any city in America.

[14][15][16] Business leaders in the mid-20th century, like Whitney Shumate, worked to improve sub-standard housing in Martinsville.

New homes were constructed in the neighborhood, built with sound materials and with all city services for the first time.

What had originally been considered a depressed civic area rapidly became a center of progress as middle class Black residents finally began to prosper.

As an editorial in the local newspaper noted, "One of the projects which won him considerable attention and praise was the instigation of the redevelopment of what was once known as Martinsville Cotton Mill Village.

Many firms closed shop and laid off thousands of workers; the production moved offshore to other countries.

[24] Founder of the Hospital Association of Virginia, Dr. Jesse Shackelford was an early advocate of comprehensive care for state citizens.

In 2008, then Illinois Democratic Senator and 44th President of the United States Barack Obama held a campaign stop in Martinsville.

[28] In August 2021, Virginia Governor Ralph Northam pardoned all 7 African-American men of the Martinsville Seven.

Martinsville was fully included in Henry County's jurisdiction until it was declared a city by court order in 1928.

However, the future of this jurisdictional arrangement became unclear when Martinsville's city council unanimously voted in favor of beginning the process of reverting from a city to a town (which would reincorporate it into the county's jurisdiction) on December 10, 2019,[34] citing economic and demographic concerns.

[35] The time frame for this reversion remains unclear, as the city's petition to revert must first be approved by a three-judge panel[35] in the state courts, after which begins a complex process of negotiation with the county over the division of responsibilities.

Stepping into the breach were several thriving plug firms which sold their merchandise across the nation beginning in the nineteenth century.

Local families were heavily involved in these companies, bestowing their names on them and reaping sizeable profits until the early twentieth century, when the tobacco monopolies created by R.J. Reynolds and James Buchanan Duke bought out most firms.

[64] (In most cases, in bold anti-competitive moves, the two tobacco titans simply shut down their acquisitions overnight.

[69] On October 28, 2021, it was announced the Colorado-based apparel and footwear company VF Corporation will continue to expand in Martinsville creating 82 new jobs, while investing $10 million into the area.

[79][80] The Piedmont Area Regional Transit (PART) operates and serves the city of Martinsville.

[83] The Blue Ridge Airport is used for general aviation and is located 9 miles (14 km) outside the city.