In the 19th century, the area that would become Belmont-Hillsboro was part of the estates of Adelicia Acklen (Belmont) and Colonel A. B. Montgomery. The oldest sections of the neighborhood were subdivided in 1890 and 1891. In 1901, the Belmont Land Company secured a franchise to operate a street railway line along Belmont Boulevard, accelerating the development of the area as a "street car suburb". Development would continue for several decades, with some of the more southerly portions of the neighborhood developed about 1940.

Changes in tastes over this span of time resulted in recognizable changes in architectural styles. The mix of bungalows, cottages, American foursquares and tudors are common, though you will find examples of the prarie, eclectic revival and more contemporary styles as well. The neighborhood became the home of a large middle-class population, reflecting the average American lifestyle from 1890 to 1940.

Following World War II, the neighborhood suffered a decline common to many older neighborhoods as cars replaced the street cars and the suburbs of Nashville continued an outward march. Declining property values, division of what had been single-family homes into multiple rental units, and lack of building maintenance presented the neighborhood with many problems.

Beginning in the 1970s, residents and new arrivals came to recognize the value of classic homes in close proximity to urban features. The process of home renovation and restoration continues today, helping the area become a very desirable Nashville address.

In the 21st century, the housing of the neighborhood exhibits a variety of architectural styles as well as size, thereby suiting a range of families and lifestyles. A portion of the neighborhood is listed in the National Register of Historic Places and is suited to contemporary living - being conveniently located to Belmont College, Vanderbilt University, Sevier Park, hospitals, shopping facilities and bus lines.

In 2005, a multi-year project to protect the architectural character and diversity of homes in the neighborhood was completed with the Metro Council's passage of the Belmont-Hillsboro Neighborhood Conservation Zoning Overlay.