Montecatini Alto is in fact the original settlement, a Romanesque castle which eventually gave birth to the modern-day city of Montecatini. At first, the only existing Montecatini was exactly that: a hilltop basin area where the now famous thermal baths were not much more than underlying wetlands. The healing properties of these waters had however already been remarked upon since the time of the Etruscans. Nevertheless it was not until 1530 that much importance was given to the springs. It was at this time that baths were built to hold the water and the thermal spas were born. Yet since the waters remained stagnant, the area was in fact a health hazard. It was the Grand Duke Leopold who had drainage channels built to rehabilitate the area. Thus, a new life was given to the new burg of Montecatini Terme, whose very name and existence are essentially tied in with the thermal baths or "terme".

The Castle of Montecatini Alto is perched up on a hill at an altitude of around 300m (almost a 1000ft). It is easy to reach by either taking the Montecatini municipal road or by funicular railway which offers great views overlooking the Valdinievole, the Nievole river valley. The village can then be reached on foot by going down an avenue bordered and shaded by plane trees. By continuing along the castle walls you'll find yourself transported into another era as you explore the little streets and squares where the splendor of yore seems intact and you almost expect to catch a glimpse of a horse carriage riding past or a farmer's wife with a basket of fresh eggs. All of the buildings have been meticulously and skillfully kept up to preserve their original appearance to ensure that they blend in perfectly with the history of the castle. The funicular railway was unveiled in 1898 and today looks like a train out of a western, but back then, it was a very modern means for providing a quick connection between the castle and the growing spa town. In the medieval square, the town's heart, there are restaurants, gelaterias and cafes and, during the spring and summer, many events are organized there which further add to the charm of this singular place.

The contemporary town of Montecatini Terme on the other hand is a beautiful and pleasant town bursting with energy. There are stores, cafes, gelaterias, restaurants and wonderful pastry shops everywhere you look. In the evenings, it's a lively place with bars, pubs and nightclubs.