[4] The area presently bounded by Kentucky state lines was a part of the U.S. State of Virginia, known as Kentucky County when the British colonies separated themselves in the American Revolutionary War.

The first settlers around this area were Elijah Combs, his seven brothers and daughter Jade Miller.

The county's economy has long been based on logging and mining coal.

Perry County is home to Hazard Community and Technical College.

It is also home to the Hazard ARH Regional Medical Center, a not-for-profit health system operating 10 hospitals, multi-specialty physician practices, home health agencies, HomeCare Stores and retail pharmacies.

23.30% of all households were made up of individuals, and 9.30% had someone living alone who was 65 years of age or older.

The coal-mining industry, high rates of smoking and obesity and a low level of physical activity appear to be contributing factors to the lowered longevity for both sexes.

Public transportation is provided by LKLP Community Action Partnership with demand-response service and scheduled service in Hazard, and connecting to Hindman, Hyden, and Whitesburg.