The historical roots of Uthai Thani, located in Thailand's central region, trace back over 3,000 years, with archaeological evidence of prehistoric human settlements such as stone tools and skeletal remains. During the Sukhothai period, settlers led by Tao Mahaphrom established a community in present-day Nong Chang district, coexisting with Mon and Karen people. Originally called “Muang Uthai,” meaning a haven for Thai people, the city was later referred to as “Uthai Thani” as it developed a reputation for fertile lands and abundant resources.

In the Ayutthaya period, the city was recognized as a strategic frontier town. The local governance structure included officials overseeing defenses against invasions, particularly from the west. Over time, Uthai Thani became an important trade center. The riverside village of Sakae Krang emerged as a bustling marketplace, attracting traders, especially Chinese merchants, who named the area “Si Kiang Kang.” The area grew as a hub for rice trade and goods like bat guano, timber, and forest products.

By the reign of King Rama IV in 1858, Uthai Thani was designated as an official administrative region, with its seat in Sakae Krang, where trade flourished. By 1898, it was integrated into Nakhon Sawan’s administrative region and later Ayutthaya, eventually gaining provincial status in 1933 when provinces became regional administrative units.