The origins of Montepagano date back to the 11th century AD. From the 13th century it became a fief of the Papal State until the French invasion of 1798. In 1927 the Commune was transferred from Montepagano to Rosburgo, then renamed Roseto degli Abruzzi. The main monuments of Montepagano are the Bell Tower, which stands for 40 m in Central Square, Gate da Borea, a remainder of the imposing medieval city walls, and the church of the Santissima Annunziata, completed in 1602.
Every first week of August it takes place in Montepagano a Wine Show, one of the oldest festivals of central Italy, a great tourist attraction.