Old Road Town was settled on January 28, 1624, by Thomas Warner, his wife Rebecca, his son Edward and 14 others.

The colony prospered and more settlements were built and by 1727, Basseterre became the capital after the expulsion of the French in 1713.

Old Road has developed with tourism, fishing, and farming industries.

There is a new fisheries complex in town, funded by the Taiwanese government.

The St. Thomas/Trinity Strikers, a football team in the Saint Kitts Premier Division (officially known as the SKNFA Digicel Premier League), are based in Old Road and the surrounding Trinity area.