The town was first settled in 1761 by Presbyterians from New England. Originally a small farming community, the construction of a railway through Truro in 1858 caused it to grow tremendously, and it was officially incorporated in 1875.
Several railways from across the province later converged in Truro, earning it the nickname "Hub of Nova Scotia". Even with the railways supplanted by roads, Truro is still at an important highway junction, where Nova Scotia Highway 102, the busiest freeway in Atlantic Canada, meets the Trans-Canada Highway.
Truro is home to Atlantic Canada's largest agricultural school, the Nova Scotia Agricultural College.