North Middletown is a Bourbon county town located at the junction of US 460 and KY 57 about nine miles southeast of Paris. Settlement began around 1800 and the village was known as Swinneytown for the owner of a local mill. It became known as Middletown for its location between Paris, Millersburg, Mount Sterling, and Winchester, but was incorporated as North Middletown in 1818 ("North" was added to distinguish it from the Jefferson county Middletown). The North Middletown post office opened in 1819. The population in 1990 was 602.