The land surrounding the falls was developed by Simon Benson in the early-twentieth century, with a pathway, viewing bridge, and adjacent lodge being constructed in 1925.

The falls attract over two million visitors each year,[2] making it the most-visited natural recreation site in the U.S. Pacific Northwest.

The falls were noted in the journals of explorers William Clark and Meriwether Lewis during their expedition through the Columbia River Gorge in 1805.

[15] Beginning in 1884, the Oregon Railway and Navigation Company operated a stop at Multnomah Falls on their railway, which spanned from Portland to Pasco, Washington; this stop continued to operate until World War II,[18] and included a timber bowstring truss bridge that spanned the falls at the present bridge's location.

On January 28, 1915, Samuel C. Lancaster recommended to the Progressive Business Men's Club of Portland that a trail be built from the base of Multnomah Falls extending to the top of Larch Mountain.

[15] The United States Forest Service appropriated a total of $1,500 and agreed to survey and build the trail in addition to the lookout on Larch Mountain.

[15] The Oregon Railroad and Navigation Company subsequently donated the land at the base of Multnomah Falls contingent upon their agreement that a lodge would be constructed at the site the same year.

[3] The rest area and tunnel under the road (as well as the Union Pacific Railroad tracks) allow Interstate travelers from either direction to stop and visit the falls.

Several tour providers offer a variety of ways to access Multnomah Falls from ebike rentals to waterfall shuttles that stop at all of the waterfalls near Multnomah Falls A paved foot trail[21] leads to Benson Footbridge, a 45-foot (14 m)-long footbridge that allows visitors to cross 105 feet (32 m) above the lower cascade.

[24] The Mark O. Hatfield Memorial Trail, one of several, starts at the falls and continues through the Oregon side of the Columbia River Gorge to Starvation Creek.

[21] On Labor Day in September 1995, a 400-ton boulder, loosened by erosion, fell 225 feet (69 m) from the face of the waterfall into the upper cascade pool, above Benson Footbridge.

The lodge reopened on November 29, 2017, though the U.S. Forest Service announced that footpath access to the waterfall would remain closed until an indeterminate date due to concerns over landslides.