Cheltenham stands on the small River Chelt, which rises nearby at Dowdeswell and runs through the town on its way to the Severn. As a royal manor, it features in the earliest pages of the Gloucestershire section of Domesday Book. The town was awarded a market charter in 1226.

Though little remains of its pre-spa history, Cheltenham has been a health and holiday spa town resort since the discovery of mineral springs by Captain Skillicorne  he immediately began improvements intended to attract visitors to his spa. He built a pump to regulate the flow of water and erected an elaborate well-house complete with a ballroom and upstairs billiard room to entertain his customers. The beginnings of Cheltenham's tree-lined promenades and the gardens surrounding its spas were first designed by Captain Skillicorne with the help of "wealthy and traveled" friends who understood the value of relaxing avenues. The area's walks and gardens had views of the countryside, and soon the gentry and nobility from across the county were enticed to come and investigate the beneficial waters of Cheltenham's market town spa.

The districts of Cheltenham include: Arle, Benhall, Charlton Kings, Fairview, Fiddler's Green, Hesters Way, Lansdown, Leckhampton, Lynworth, Montpellier, Oakley, Pittville, Prestbury, the Reddings, Rowanfield, St Luke's, St Mark's, St Paul's, St Peter's, Springbank, Swindon Village, Tivoli, Up Hatherley, Whaddon and Wyman's Brook.