Located in the lower Hudson Valley, Middletown was first settled in 1760 and quickly grew into a thriving dairy farming center. With the arrival of the pioneering New York and Erie Rail Road in 1843, Middletown continued to flourish, and by 1888, it became a city. Hundreds of residents found employment in the growing railroad industry as well as at the sprawling Middletown State Hospital, with its advanced facilities at one time boasting over 100 buildings. Middletown Revisited documents the rich history of a city that has continued to grow over generations.