Salem, one of the earliest planned communities in the colonies, was founded in 1766 by the Moravians, as the central town in Wachovia. These Moravian artisans opened sawmills, breweries, and tanneries, and the town grew and prospered. In 1849, Winston was founded by settlers of Quaker and European descent, located just north of the Salem settlement. Also in 1849, the North Carolina legislature created the new County of Forsyth out of part of Stokes County. Forsyth County was named in honor of Colonel Benjamin Forsyth, a respected Stokes County landowner who fought and died in the War of 1812. Winston was known to be a major producer of furniture, tobacco products and textiles. Winston was named the seat of Forsyth County in 1851. The courthouse square was laid one mile north of Salem Square with plans for the street of the two towns to run together.

The two cities were merged by the postal service, of all things, by the simple combination of the Winston and Salem post offices and a hyphen placed between their names on the new postmark in 1899. The hyphen became permanent in 1913 when Salem and Winston joined and the "Twin City" of Winston-Salem emerged.

Since that time, Winston-Salem has grown to be an area known for its diversity of business & community, a strong & unwaivering commitment to the arts, excellence in healthcare & technology, many opportunities for specialized & advanced education, and a high quality of life with a low cost of living. Surrounding communities, such as Clemmons, Tanglewood, Lewisville, King, Walnut Cove, Walkertown, Pfafftown, Rural Hall, and Advance are growing, too, in response to the area’s steady development and industry growth.