Prior to European colonization a large Cherokee settlement existed within the borders of Mills River.

Mills River is among the oldest communities in Henderson County, with its first landholder receiving a deed from the state of North Carolina in 1788.

It is bordered to the northeast by the city of Asheville and the town of Fletcher, and to the south by the unincorporated communities of Horse Shoe and Etowah.

The current mayor is Shanon Gonce, who took office in December 2021, elected by his fellow town council members.

The current town council members are Randy Austin (2019), Jeff Young (appointed March 2022), James Cantrell (2021), and Sandra Goode (2021).