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At the time of the establishment of the Plymouth Colony in 1620, the area that would one day become Troy City was inhabited by the Pokanoket Wampanoag tribe, headquartered at Mount Hope in what is now Bristol, Rhode Island. The "falling" river that the name Fall River refers to is the Quequechan River (pronounced "quick-a-shan" by locals) which flows through the city, dropping steeply into the bay. Quequechan is a Wampanoag word believed to mean "falling river" or "leaping/falling waters." During the 1960s, Interstate 195 was constructed through the city along the length of the Quequechan River. The portion west of Plymouth Avenue was routed underground through a series of box culverts, while much of the eastern section "mill pond" was filled in for the highway embankment.

In 1653, Freetown was settled at Assonet Bay by members of the Plymouth Colony, as part of Freeman's Purchase, which included the northern part of what is now Fall River. In 1683, Freetown was incorporated as a town within the colony. The southern part of what is now Fall River was incorporated as the town of Tiverton as part of the Massachusetts Bay Colony in 1694, a few years after the merger with Plymouth Colony. In 1746, in the settlement of a colonial boundary dispute between Rhode Island and Massachusetts, Tiverton was annexed to Rhode Island, along with Little Compton and what is now Newport County, Rhode Island. The boundary was then placed approximately at what is now Columbia Street.

In 1703, Benjamin Church, a hero of King Philip's War established a saw mill, grist mill, and a fulling mill on the Quequechan River. In 1714, Church sold his land, along with the water rights to Richard Borden of Tiverton and his brother Joseph. This transaction would prove to be extremely valuable 100 years later, helping to establish the Borden family as the leaders in the development of Fall River's textile industry.

During the 18th century the area consisted mostly of small farms and relatively few inhabitants. In 1778, the Battle of Freetown, was fought here during the American Revolutionary War (1775-1783) after British raids badly damaged Bristol and Warren. The militia of Fall River, at that time known as Freetown, put up a stronger defense against a British force.

In 1803, Fall River was separated from Freetown and officially incorporated as its own town. A year later, Fall River changed its name to "Troy." The name "Troy" was used for 30 years and was officially changed back to Fall River on February 12, 1834. During this period, Fall River was governed by a three-member Board of Selectmen, until it became a City in 1854.

In 1835, The Fall River Female Anti Slavery Society was formed (one of the many anti slavery societies in New England) to promote abolition and to allow a women's space to conduct social activism. There was an initial group, which was wary of allowing free black full membership, so a second group (this one) was formed in response by Elizabeth Buffum Chace and her sisters, who were committed to allowing free black women membership. A delegate from the group was sent to the Anti-Slavery Convention of American Women, a Philadelphia convention in 1838. Her name was Sarah G. Buffman, and she signed all three of the statements that the convention's delegates agreed on.

In July 1843, the first great fire in Fall River's history destroyed much of the town center, including the Atheneum, which housed the Skeleton in Armor which had been discovered in a sand bank in 1832 near what is now the corner of Hartwell and Fifth Street.

During this time, the southern part of what is now Fall River (south of Columbia Street) would remain part of Tiverton, Rhode Island. In 1856, the town of Tiverton, Rhode Island voted to split off its industrial northern section as Fall River, Rhode Island. In 1861, after decades of dispute, the United States Supreme Court moved the state boundary to what is now State Avenue, unifying both Fall Rivers as a city in Massachusetts (among other changes; see History of Massachusetts § Rhode Island eastern border). For many years RI and Massachusetts fought over parts of cities and states boundaries. Also the state since Roger Williams started Providence plantations when he started it as a land. Eventually changed to Rhode Island and Providence Plantations to england to be a colony. At the time Plantations means land/farm. During this they eventually did change Massachusetts traded the other half of the city of Pawtucket to RI. The division of Pawtucket was the River. The birthplace of the American Revolution. Massachusetts also trade Rumford area which is part of East Providence. FallRiver and Seekonk became part of Rhode Island’s trade time gain their land.

The early establishment of the textile industry in Fall River grew out of the developments made in nearby Rhode Island beginning with Samuel Slater at Pawtucket in 1793. In 1811, Col. Joseph Durfee, the Revolutionary War veteran and hero of the Battle of Freetown in 1778 built the Globe Manufactory (a spinning mill) at the outlet of Cook Pond on Dwelly St. near what is now Globe Four Corners in the city's South End. (It was part of Tiverton, Rhode Island at the time.) While Durfee's mill was never very successful, it marked the beginning of the city's rise in the textile business.

The real development of Fall River's industry, however, would occur along the falling river from which it was named, about a mile north of Durfee's first mill. The Quequechan River, with its eight falls, combined to make Fall River the best tidewater privilege in southern New England. It was perfect for industrialization—big enough for profit and expansion, yet small enough to be developed by local capital without interference from Boston.

The Fall River Manufactory was established by David Anthony and others in 1813. That same year, the Troy Cotton & Woolen Manufactory was also founded, by a group of investors led by Oliver Chace, from Swansea, who had worked as a carpenter for Samuel Slater in his early years. The Troy Mill opened in 1814, at the upper end of the falls.

In 1821, Colonel Richard Borden established the Fall River Iron Works, along with Maj. Bradford Durfee at the lower part of the Quequechan River. Durfee was a shipwright, and Borden was the owner of a grist mill. After an uncertain start, in which some early investors pulled out, the Fall River Iron Works was incorporated in 1825. The Iron Works began producing nails, bar stock, and other items such as bands for casks in the nearby New Bedford whaling industry. They soon gained a reputation for producing nails of high quality, and business flourished. In 1827, Col. Borden began regular steamship service to Providence, Rhode Island.

The American Print Works was established in 1835 by Holder Borden, uncle of Colonel Richard. With the leadership of the Borden family, the American Print Works (later known as the American Printing Company) became the largest and most important textile company in the city, employing thousands at its peak in the early 20th century. Richard Borden also constructed the Metacomet Mill in 1847, which today is the oldest remaining textile (cloth-producing) mill in the city, located on Anawan Street.

By 1845, the Quequechan's power had been all but maximized. The Massasoit Steam Mill was established in 1846, above the dam near the end of Pleasant Street. However, it would be another decade or so when improvements in the steam engine by George Corliss would enable the construction of the first large steam-powered mill in the city, the Union Mills in 1859.

The advantage of being able to import bales of cotton and coal to fuel the steam engines to Fall River's deep water harbor, and ship out the finished goods also by water, made Fall River the choice of a series of cotton mill magnates. The first railroad line serving Fall River, The Fall River Branch Railroad, was incorporated in 1844 and opened in 1845. Two years later, in 1847, the first regular steamboat service to New York City began. The Fall River Line as it came to be known operated until 1937, and for many years, was the preferred way to travel between Boston and Manhattan. The Old Colony Railroad and Fall River Railroad merged in 1854, forming the Old Colony and Fall River Railroad.

In 1854, Fall River was officially incorporated as a city, and had a population of about 12,000. Its first mayor was James Buffington.

Fall River profited well from the American Civil War and was in a fine position to take advantage of the prosperity that followed. By 1868, it had surpassed Lowell as the leading textile city in America with over 500,000 spindles.

In 1871 and 1872, a "most dramatic expansion" of the city occurred: 15 new corporations were founded, building 22 new mills throughout the city, while some of the older mills expanded. The city's population increased by 20,000 people during these two years, while overall mill capacity doubled to more than 1,000,000 spindles.^{[citation needed]}

By 1876, the city had one sixth of all New England cotton capacity and one half of all print cloth production. The "Spindle City" as it became known, was second in the world to only Manchester, England.

To house the thousands of new workers, mostly Irish and French Canadian immigrants during these years, over 12,000 units of company housing were built. Unlike the well-spaced boardinghouses of the tidy cottages of Rhode Island, worker housing in Fall River consisted of thousands of wood-framed multi-family tenements, usually three-floor "triple-deckers" with up to six apartments. Many more privately owned tenements supplemented the company housing.

During the 19th century, Fall River became famous for the granite rock on which much of the city is built. Several granite quarries operated during this time, the largest of which was the Beattie Granite Quarry, near what is now North Quarry Street, near the corner of Locust. Many of the mills in the city were built from this native stone, and it was highly regarded as a building material for many public buildings and private homes alike. The Chateau-sur-Mer mansion in Newport, Rhode Island is perhaps the best example of Fall River granite being used for private home construction.

While most of the mills "above the hill" were constructed from native Fall River granite, nearly all of their counterparts along the Taunton River and Mount Hope Bay were made of red brick. This was due to the high costs and impracticality associated with transporting the rock through the city and down the hill, where there were no rail lines because of the steep grades. (One notable exception is the Sagamore Mills on North Main Street, which were constructed from similar rock quarried in Freetown and brought to the site by rail.)

Fall River rode the wave of economic prosperity well into the early 20th century. During this time, the city boasted several fancy hotels, theaters, and a bustling downtown. As the city continually expanded during the late 19th century, its leaders built several fine parks, schools, streetcar lines, a public water supply, and sewerage system to meet the needs of its growing population.

From 1896 to 1912, Fall River was the headquarters of the E. P. Charlton & Company chain of five and ten cent stores. Founded at Fall River in 1890 by Seymour H. Knox and Earle Perry Charlton as the Knox & Charlton Five and Ten Cent Store, by the time of its merger with several other retailers to form the F. W. Woolworth Company in 1912, Charlton operated fifty-eight stores in the United States and Canada.

In 1920 the population of Fall River peaked at 120,485.

The cotton mills of Fall River had built their business largely on one product: print cloth. About 1910, the city's largest employer, the American Printing Company (APC), employed 6,000 people and was the largest company printer of cloth in the world. Dozens of other city mills solely produced cloth to be printed at the APC. The city's industry had all its eggs in one, very large basket.

World War I had provided a general increase in demand for textiles, and many of the mills of New England benefited during this time. The post-war economy quickly slowed, however, and production quickly outpaced demand. The Northern mills faced serious competition from their Southern counterparts due to factors such as lower labor and transportation costs, as well as the South's large investment in new machinery and other equipment. In 1923, Fall River faced the first wave of mill closures. Some mills merged and were able to limp along until the late 1920s. By the 1930s and the Great Depression, many more mills were out of business and the city was bankrupt. A few somehow managed to survive through World War II and into the 1950s.

The worst fire in Fall River's history occurred on the evening of February 2, 1928. It began when workers were dismantling the recently vacated Pocasset Mill. During the night the fire spread quickly and wiped out a large portion of downtown. City Hall was spared but was badly damaged. Today, many of the structures near the corner of North Main and Bedford Street date from the early 1930s, as they were rebuilt soon after the fire.

The once mighty American Printing Company finally closed for good in 1934. In 1937, their huge plant waterfront on Water Street was acquired by the Firestone Tire & Rubber Company and soon employed 2,600 people. In October 1941, just a few weeks before the attack on Pearl Harbor, a huge fire broke out in the old 1860s' main building of the print works. The fire was a major setback to the U.S. war effort, as $15 million in raw rubber (30,000 lbs.) was lost in the inferno.

With the demise of the textile industry, many of the city's mills were occupied by smaller companies, some in the garment industry, traditionally based in the New York City area but attracted to New England by the lure of cheap factory space and an eager workforce in need of jobs. The garment industry survived in the city well into the 1990s but has also largely become a victim of globalization and foreign competition.

In the 1960s the city's landscape was drastically transformed with the construction of the Braga Bridge and Interstate 195, which cut directly through the heart of the city. In the wake of the highway building boom, the city lost some great pieces of its history. The Quequechan River was filled in and re-routed for much of its length. The historic falls, which had given the city its name, were diverted into underground culverts. A series of elevated steel viaducts was constructed as to access the new Braga Bridge. Many historic buildings were demolished, including the Old City Hall, the 150-year-old Troy Mills, the Second Granite Block (built after the 1928 fire), as well as other 19th century brick-and-mortar buildings near Old City Hall.

Constructed directly over Interstate 195, where its predecessor was, the new city hall was opened in 1976, after years of construction delays and quality control problems. Built in the Brutalist style popular in the 1960s and 1970s, the new city hall drew complaints from city workers and residents almost immediately.

In 1970 the Valle's Steak House chain opened one if its landmark restaurants on William S. Canning Boulevard. The steak house was popular with Fall River residents but economic challenges caused the chain to close all of its restaurants in the 1980s.

Also during the 1970s, several modern apartment high-rise towers were built throughout the city, many part of the Fall River Housing Authority. There were two built near Milliken Boulevard, two on Pleasant Street in Flint Village, another on South Main Street, and in the north end off Robeson Street. Today, these high-rises mostly house the elderly.

In 1978, the city opened the new B.M.C. Durfee High School in the north end, replacing the historic Rock Street masterpiece that had become overcrowded and outdated for use as a high school. The "new" Durfee is one of the largest high schools in Massachusetts.

Since about 1980, there has been a considerable amount of new development in the North end of the city, with many new single- and multi-family housing developments, particularly along North Main Street.

In 2018, Fall River was ranked the 77th most dangerous city in the United States.Fall River is also the most dangerous city in Massachusetts and second most dangerous city in New England.

On January 20, 2019, a cannabis dispensary opened in Fall River, becoming only the sixth dispensary in Massachusetts and the first in Southeastern Massachusetts to open to anyone 21 years or older.

According to the United States Census of 2010, the population of Fall River is 88,857. The largest racial groups within the city were 87.2% (83.4% Non-Hispanic) White, 3.5% African American, 2.5% Asian and 0.2% Native American and 7.4% Hispanic or Latino. 49% of residents are Luso American or have origins somewhere in the former Portuguese Empire. 37% of the population described themselves as being of Portuguese ancestry. The next largest groups by ancestry are French 12.4%, Irish 8.9%, Cape Verdean 8.1%, English 6.0%, French Canadian 5.9%, Puerto Rican 4.5%, and Italian 3.6%.

Fall River and surrounding communities form a part of the Providence metropolitan area, which has an estimated population of 1,622,520.

In percentage terms, Fall River has the largest Portuguese American population in the United States. However, the exact percentage of the population they make up is disputed. A 2005 study by the University of Massachusetts Dartmouth has given it at 49.6% while other sources give it as 43.9%.

The city has 38,759 households and 23,558 families. The population density was 2,963.7 per square mile (1,144.3/km²). There were 41,857 housing units at an average density of 1,349.3 per square mile (521.0/km²). Of the 38,759 households, 29.9% had children under the age of 18 living with them, 40.3% were married couples living together, 16.5% had a female householder with no husband present, and 39.2% were non-families. 34.2% of all households were made up of individuals, and 14.2% had someone living alone who was 65 years of age or older. The average household size was 2.32 and the average family size was 3.00.

In terms of age, the population was spread out, with 24.1% under the age of 18, 9.2% from 18 to 24, 29.8% from 25 to 44, 20.0% from 45 to 64, and 16.9% who were 65 years of age or older. The median age was 36 years. For every 100 females, there were 87.7 males. For every 100 females age 18 and over, there were 82.9 males.

The median household income was $29,014, and the median family income was $37,671. Males had a median income of $31,330 versus $22,883 for females. The per capita income for the city was $16,118. About 14.0% of families and 17.1% of the population were below the poverty line, including 25.4% of those under age 18 and 17.4% of those age 65 or over.

Data is from the 2009–2013 American Community Survey 5-Year Estimates.