Malcolm McMillan, an early settler in the area that is now Vidalia, pitched his camp near this site around 1800 and built his pioneer home there. In the years that followed, he and his cousin, the Rev. Murphey McMillan, established a Presbyterian church and cemetery on the site. For the next 100 years, it served as the principal cemetery for the loose community of farmers, loggers, and sheepherders in what was then eastern Montgomery County. The McMillans are believed to be buried there in now unmarked graves. Many of the older wooden markers that were once common there no longer exist, and the large open areas of the cemetery contain graves without markers rather than vacant ground. Sterling, one of the first towns established near the site in 1850, has many of its residents buried there. With the arrival of the railroads in the late 1880s, the cemetery also served nearby communities that sprang up along the rail route, including Aimwell, Appleton, Bandanna, Jenkins Station, Stacers, Straw, and Tosh. After Vidalia was founded in 1890, these early towns gradually disappeared. When Pinecrest Cemetery was created in 1907, the site ceased to be the area's primary cemetery and was often known as the Church Street cemetery, the Primitive Baptist cemetery, and the Old Vidalia City cemetery.