Saxapahaw was first settled by the Sissapahaw Indians, a hunting and farming tribe. In 1701, explorer and surveyor John Lawson visited the area and called it "the flower of the Carolinas." In the mid-1700s, the first European settlers came to the area. In 1768, Thomas Thompson built the first grist mill on the Haw River at Saxapahaw, paving the way for the development of this community.