The name of the city comes in fact from the Lombardic word pehhia (cognate to Bach in German), meaning "river".

During the entire Middle Ages Florence and Lucca contended for the city, as the latter was located on the border between the two republics.

Heavily struck by the Black Death, Pescia overcame the demographic and economic depression which had ensued only at the end of the 15th century.

Since 1925 Pesciatins found an alternative economic source in cultivating and trading flowers and olive plants (since the end of the 19th century).

Economic activities in and around the city include flower growing (carnations, for which it is an international market center) and paper production.