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Elizabethtown is the county seat of Bladen County and one of the oldest communities in southeastern North Carolina. The area was originally inhabited by Indigenous peoples who lived along the Cape Fear River and its tributaries, relying on the region's fertile soils, forests, and waterways for sustenance and trade. European settlement began in the early eighteenth century as colonists moved inland from the coast. Bladen County was formed in 1734, making it one of the earliest counties in North Carolina, and Elizabethtown emerged as an important administrative and trading center due to its strategic location along the Cape Fear River.

Agriculture and river-based commerce drove Elizabethtown's early economy. Farmers in the surrounding countryside produced crops such as corn, rice, tobacco, and later cotton, which were transported by boat along the Cape Fear River to coastal ports. The river also facilitated the movement of naval stores, including tar, pitch, and turpentine, which were vital to the colonial economy. As a result, Elizabethtown developed into a hub for trade and commerce, supporting merchants, warehouses, and related services.

Transportation infrastructure continued to shape Elizabethtown's growth throughout the nineteenth and twentieth centuries. River traffic remained important until the expansion of road and rail systems offered new options for moving goods and people. Roads connecting Elizabethtown to other towns in Bladen County and neighboring counties improved accessibility and reinforced its role as a regional center. Bridges and highway improvements further integrated the town into southeastern North Carolina's transportation network, supporting both commerce and residential development.

Elizabethtown's community character has long been influenced by its status as county seat. Courthouses, government offices, and civic institutions brought professionals and visitors to the town, fostering a stable local economy and civic culture. Schools, churches, and civic organizations contributed to social life and community engagement. Over time, Elizabethtown developed a diverse population and a strong sense of local pride rooted in its long history and civic importance.

Today, Elizabethtown offers a blend of historic charm and modern convenience. Residential neighborhoods range from historic homes to newer developments, while the downtown area continues to serve as a center for government, commerce, and community events. Parks, river access, schools, and healthcare facilities enhance quality of life for residents. Elizabethtown remains an important anchor for Bladen County, valued for its heritage, accessibility, and welcoming small-town atmosphere.