The lands of the current Pieštany District have been inhabited since the Paleolithic era, but many archaeological findings are dated even earlier, for example the known Venus of Moravany is dated from the earlier Stone Ages (22,800 BC).

In the 1st century AD, it was centre of Germanic kingdom in the Váh region.

The area suffered in the 15th and again in the 16th and particularly 17th centuries, first when the Hussites were warring, and not put out until 1473, with their last stand near Veľké Kostoľany captured by the forces of the Matthias Corvinus.

The Ottomans encroaching from the south were threatening the area mainly since 1663, after fall of the Nové Zámky fortress, but were put out near the end of the 17th century.

During the wartime Slovak Republic, it was part of the extended Trenčín county.