The village of Saranac Lake covers parts of three towns (Harrietstown, St. Armand, and North Elba) and two counties (Franklin and Essex).

As the Iroquois, mostly allies of the British, had been forced to cede their land to the United States following the war, millions of acres of New York were opened up to non-Native development in the postwar period.

In 1827, settlers Pliny Miller and Alric Bushnell established a logging facility with a dam and sawmill, around which the village developed.

In 1876, Dr. Edward Livingston Trudeau arrived from New York City to treat his tuberculosis (TB) by a stay in the mountains.

Dry, cold air was considered to be good for patients, and sanitariums were also founded in European mountain resorts.

Little Red, the first "cure cottage", was built on a small patch of land on the north side of Mount Pisgah.

As more patients visited the region, including author Robert Louis Stevenson in 1887, Trudeau's fame grew.

[6] Soon, the sanitarium had grown to such size that it was entitled to its own post office, which delivered mail to the many patients.

In 1964, the Trudeau Institute began researching the functions of the immune system and how it guards against many infectious diseases, including tuberculosis.

William S. Fowler was a real estate speculator and developer who owned several properties around Saranac Lake.

E. F. Albee, the owner and President of the National Vaudeville Artists, held benefit programs in New York City to raise funds to construct the large sanitarium.

Telephone service was introduced in 1884, and the Chateaugay branch of the Delaware and Hudson Railroad reached Saranac Lake from Plattsburgh in 1887.

Five years later, the Mohawk and Malone Railway main line reached nearby Lake Clear Junction.

Electricity was introduced on September 20, 1894, by installing water wheels on the former site of Pliny Miller's mill.

At the same time, the village began to develop municipal facilities, such as public schools, and fire and police departments.

In 1892, John Rudolphus Booth, the Canadian lumber king, rented a cottage at Saranac Lake for his daughter, who used it for several years in seeking a TB cure.

[7] Starting in the 1890s and for the next 60 years, Saranac Lake was known as "the Western Hemisphere's foremost center for the treatment of pulmonary tuberculosis".

Among the last of the prominent patients who sought treatment for tuberculosis was Manuel Luis Quezon y Molina, the first Filipino president of the Commonwealth of the Philippines, who died in Saranac Lake of the disease on August 1, 1944.

They added to and supported the culture of the area, as did the wealthy who built Great Camps on the nearby Saranac and Saint Regis Lakes, the effect was to change the sleepy village of 300 of the 1880s into the vibrant "little city" of 8,000.

Gangster Legs Diamond visited his brother Eddy, who had TB and stayed at a local cottage sanatorium.

[12] During World War II, Einstein summered frequently at Knollwood Club on Lower Saranac Lake.

[12] In 1954, Saranac Lake hosted the world premiere of the Biblical epic film The Silver Chalice, in which actor Paul Newman made his debut.

The Winter Carnival parade reflects the theme, and Garry Trudeau, the creator of the comic strip Doonesbury who grew up in the town, creates artwork with characters from his comic strip doing things related to the theme for a button that can be purchased each winter.

[20] Saranac Lake has a number of galleries, the Adirondacks' only year-round, professional theatre, monthly art walks June through September, and a Plein Air festival.

[21][better source needed][22] The organization Saranac Lake ArtWorks is composed of dozens of artists and arts-related businesses.

The organization has completed the restoration of Edward Livingston Trudeau's 1894 Saranac Laboratory, now a museum, and the 1904 Union Depot.

[25] The writer Robert Louis Stevenson spent the winter of 1887 in a cottage in Saranac Lake, which still stands, and serves as a museum dedicated to his life.

[26] The cartoonist Garry Trudeau, who draws the Doonesbury comic strip, was raised in Saranac Lake and has maintained his connections there.

[27] Stuntwoman Leslie Hoffman was born in Saranac Lake and came back to home to retire from the Entertainment Business.

After the local Ames Department Store closed due to bankruptcy and residents were forced to travel 50 miles to Plattsburgh for many consumer goods, the town was approached by Walmart, which offered to build a 120,000 square foot supercenter, but the community declined the offer, fearing that Walmart would negatively impact local business and increase traffic.