Originally known as 'Lords Hill', this area west of downtown Hartford was primarily farmland and named after one of the city's original settlers. In 1807 the Asylum for the Education and Instruction of Deaf and Dumb Persons was founded and its first student, Alice Cogswell, was enrolled. She is depicted in a commemorative statue, designed by Frances Wadsworth, that honors Thomas Hopkins Galludet, Mason F. Cogswell and Laurent Clerc, founders of the American School for the Deaf, which was the first of its kind in the country. Thereafter, the area was known as Asylum Hill.

In the early 1800s, the area was dominated by the 100-acre Imlay farm, which occupied most of the land from present-day Imlay Street west to the north branch of the Park River, and from Farmington Ave. south to the Park River. John Hooker and Francis Gillette purchased the farm in 1853 for the purpose of developing the real estate. They built their own homes and encouraged friends to do the same. As a result, a literary colony took hold that included Isabella Beecher Hooker, the Gillettes, Charles Dudley Warner, Harriet Beecher Stowe, Samuel Clemens, as well as reformers and activistts and others. The area became known as Nook Farm. The homes were designed by leading architects of the day and some still survive. Most notably, the homes of Samuel Clemens who, under the pseudonym Mark Twain penned some of his most notable works, including The Adventures of Tom Sawyer and A Connecticut Yankee in King Arthur's Court. Nook Farm also included the home of Harriet Beecher Stowe, best known as the author of Uncle Tom's Cabin. These, along with the Katherine Day House are museums open to the public.

The Hartford Fire Insurance Company was founded in 1810. Its symbol, the stag, was taken from the 16th century seal of the town of Hertford, England. The 10-acre campus on which it is located was the site of Hartford's first reservoir, and later the location of the original American School for the Deaf. One notable employee of The Hartford was Wallace Stevens who became a Pulitzer Prize-winning poet in 1955. Each day, he would walk the two miles from his home in the West End to work, often using the time to compose poetry. A group called "The Friends and Enemies of Wallace Stevens" commemorated this by having 13 granite stones with inscriptions from Stevens' poetry spaced along the route from Westerly Terrace to The Hartford.

The Hartford was the first major corporation to move into the neighborhood, followed by the Rossia Insurance Company and the Aetna Life Insurance Company. This generated a demand for lower-cost housing by clerical workers moving into the area.

As a residential area, the neighborhood has a mix of apartment buildings and multi-family houses. The Northside Institutions Neighborhood Alliance (NINA) is a nonprofit that was organized to foster the revitalization of the neighborhood. Over a dozen historic properties have been rehabilitated for home ownership.

A number of significant religious institutions are located in the neighborhood, including Asylum Hill Congregational Church which was organized in 1864 by a group of wealthy residents in the neighborhood. Designed by Irish-born architect Patrick C. Keely, its first pastor, Joseph Twichell, was a constant companion to and advisor of Samuel Clemens. The two men took very long walks–often, going the 8 miles to Talcott Mountain–to discuss life and phillosophy. Twichell is buried at Cedar Hill Cemetery.

Trinity Episcopal Church is built in the 19th Century Gothic Revival style. When it was constructed in the 1890s the congregation deliberately chose to abandon the centuries-old practice of subscription pews, marked with “owners” plaques. Wishing to be a more open church, welcoming all as equals, chairs were put in place and these remain today.

Patrick C. Keely also designed the original Cathedral of St. Joseph, a twin-towered brownstone structure that was built on the old Morgan estate and consecrated in 1879. On the last day of December,1956, the cathedral's wooden ceiling caught fire, windows shattered and the the roof caved in. Nothing of the structure could be salvaged and it was demolished. Reconstruction on the same site was begun almost immediately and the new cathedral was dedicated in1962.

Asylum Hill also was home to many educational institutions. The original Hartford Public High School was designed by architect George Keller, but was demolished in 1963 in favor of construction of Interstate 84. Today a stone marker honors the institution. It reads, in part:

In 1897, the Sisters of Saint Joseph of Chambéry opened a two-room hospital that offered a refuge for immigrants who wanted to know that their faith and traditions would be understood and appreciated if they ever needed inpatient care. From this unassuming beginning has grown the medical facility now known as Saint Francis Hospital, the largest Catholic health care provider in New England. A teaching hospital, it is affiliated with the University of Connecticut Schools of Medicine and Dentistry.

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