The teams are located in cities situated on the Ohio River and are separated by roughly 100 miles of Interstate 71.

[1] Before the formation of Louisville City and FC Cincinnati, various soccer clubs, both professional and amateur, played in the respective regions.

[4] In 2016, the affiliation ended with Orlando City creating its own reserve team to field in USL.

[11] The two teams played their first match on April 16, 2016, at Nippert Stadium in Cincinnati in front of a then-USL-record crowd of 20,497.

Cincinnati jumped to an early lead over Louisville with a sixth-minute goal from Austin Berry.

USL golden boot winner, Sean Okoli scored the insurance goal.

The rivalry continued into its second season when Louisville visited Cincinnati for a USL match on Saturday, April 22, 2017.

[12] Tensions rose between the clubs after an incident in the 87th minute, when Cincinnati forward Djiby Fall was shown a straight red card and then briefly had an exchange of words with Louisville midfielder Niall McCabe before exiting the pitch.

In a post-match interview, Louisville head coach James O'Connor alleged Djiby bit McCabe's cheek during this exchange.

[13] FC Cincinnati denied the claims the next day, writing in a statement, "We have seen no evidence to substantiate the allegations made by Louisville City Head Coach James O'Connor and it is our belief his post-match comments are not true.

[17] The two clubs did not meet again until the next season, when Louisville won 1–0 at FC Cincinnati's home opener on April 7, 2018.