The Hill began with immigrants from Northern Italy, Germany, Ireland, and African-Americans who wanted to live near the railroad which connected the neighborhood to downtown.

The structure, designed by architect Angelo Corrubia,[5] was modeled after the Sant'Ambrogio Church in Milan, in a Lombard Romanesque Revival style of brick and terra cotta.

Baseball greats Yogi Berra and Joe Garagiola grew up on the Hill; their boyhood homes are across the street from each other on Elizabeth Avenue.

Four of the five St. Louisans on the US soccer team that defeated England in the 1950 FIFA World Cup came from The Hill, a story that is told in The Game of Their Lives, a book (ISBN 0-8050-3875-2) and 2005 film of the same title (released on DVD as The Miracle Match).

Other talent from The Hill includes Toni Carroll who made a singing career in New York in the 1950s and 60s, appearing on Broadway and at the Copacabana.

[8] On June 13, 2020, Black Lives Matter protests overtook the Hill as the neighborhood has struggled with racism and bigotry against African Americans.