Middletown was incorporated in 1743 and is named for its position on Aquidneck Island.

Sandwiched between Newport and Portsmouth, this town of 13 square miles has more building and commercial activity than either of the other island communities. It also has some of the most beautiful beaches and shoreline. The Norman bird sanctuary and Sachuest Point National Wildlife Refuge host waterfowl and migratory birds and provide a breathtaking walking trail along the Sakonnett River.