"[2] The courthouse occupies one of the most prominent locations in the city of Lexington, close to the exact geographic center of the urban agglomeration, in the Downtown Commercial [Historic] District.

[1] The plan of the courthouse uses the shape of a Greek cross, although the National Register nomination for the surrounding historic district describes the building's overall volume as "more of a (half-)cube or pyramid with re-entrant angles.

On all sides but the north, a terrace on top of the basement wraps around the structure, and on the south façade in front of the main entrance this opens onto a grand flight of stone steps flanked by two large bronze lamps that sit on richly-carved pedestals.

[1] The courthouse rises four stories, including the basement, below the main roofline and its major elements are symmetrical around the north–south axis, with identical windows flanking the central protruding bays on each façade.

[1] The square-plan drum is pierced by a series of tall round-arched windows and framed by four thin round-plan conical towers, one at each corner, which are connected by another elaborated corbelled cornice.

Clocks set into gabelled dormers sit at the center of the drum on each façade, behind which an octagonal-plan dome rises in a curved mansard shape to an arcaded, columnar bronze lantern at its summit that uses a bell-shaped cap, originally topped with a horse-shaped weathervane.

The previous courthouse, built in 1887 and designed by Thomas Boyd, used a neoclassical style with a central dome and also faced W. Main Street to the south.

The National Register nomination for Lexington's Downtown Commercial [Historic] District quotes the architects at the dedication of the structure in February 1900 as declaring that "the style of architecture should be characteristic of the purpose for which the building design is used.

The grand staircase was dismantled, the space of the courtrooms and other offices on the second floor were redistributed and remodeled, losing most of their original decor, and the rotunda was covered in order to install a new air conditioning system.

Nonetheless, the building was included in the survey of Lexington's Downtown Commercial [Historic] District when it was conducted in the early 1980s and filed with the National Park Service in August 1983.

[11] In 2012, the museums were forced to vacate the Old Courthouse when the Urban County Government discovered hazardous lead paint and mold as part of an environmental survey.

The Old Courthouse reopened in late 2018 as a multi-purpose structure that integrates a municipal visitor's center, cafés, civic offices, and special event spaces.

Whatever we did here needed to be a beacon for the future and not just a curio of the past.”[3][11] The courthouse was built adjacent to Cheapside Park, the former site of slave auctions and trading during the nineteenth century; these had ceased by 1866 with the abolition of slavery.

[14] These statues had been erected as part of an effort to enforce white supremacy and perpetuate anti-black racism during the nadir of American race relations at the turn of the twentieth century.

In November 2015, the Urban County Arts Review Board recommended the removal of both statues as part of the larger reconsideration of Confederate monuments in the United States.