Fort Hill Earthwork was built 2000 years ago by indigenous people who flourished in the temperate deciduous forest of Eastern North America. The exact ancestral lineages and languages that united the earthwork builders over their many generations of activity remain unknown, so they are usually referred to simply as the Hopewell Culture, a modern term. Southern Ohio was the epicenter of the Hopewell Culture's far-flung influence in eastern North America and the setting for what many historians believe was the highest artistic expression of any native culture in Eastern North America, before or since. The Hopewell Culture is best known for roughly two dozen giant ceremonial earthwork complexes, outlined by circular and square walls built along major southern Ohio floodplains, but Fort Hill represents an alternative form of Hopewell earthen architecture found on hills with flat, mesa-like ridge tops, of which only a dozen have ever been found. One of the best preserved of these hilltop earthworks, Fort Hill has tall walls of earth and stone that follow the irregular contour of the outer rim of the bluffs, interrupted by multiple gateways, though the exact use of this lofty gathering space is unknown.