Originally the southern part of Sanbornton, the present area of Tilton was known as Sanbornton Bridge and Bridge Village. These two names refer to the bridge, built in 1763, that crossed the Winnipesaukee River from Canterbury to Sanbornton and onto what is now Main Street in Tilton. In 1869, Sanbornton Bridge was set off and incorporated as Tilton, named in honor of Nathaniel Tilton, whose grandson Charles E. Tilton was the owner of textile mills and the community's wealthiest citizen. Nathaniel Tilton established an iron foundry and the area's first hotel, the Dexter House. Charles E. Tilton donated many statues to the town, a unique feature, and his estate is now part of the Tilton School. Tilton Hall, his former mansion built in 1861, houses the Lucian Hunt Library. The attached carriage house was renovated in 1980 to become the Helene Grant Daly Art Center.

Charles E. Tilton also donated what is perhaps the most notable landmark in the area, the hilltop Memorial Arch, located in the neighboring town of Northfield, across the Winnipesaukee River from the center of Tilton. The Roman arch replica was built in the late 1800s as a memorial to his ancestors. It is built of Concord granite, 50 feet (15 m) high and 40 feet (12 m) wide.

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