The area around Piatra Neamț is one of the oldest inhabited regions in Romania. The oldest traces of human civilisation in this part of the country date back to the higher Paleolithic era, around 100,000 years B.C. The Cucuteni culture, the development of which lasted approximately one thousand years is exemplified by around 150 settlements in the territory of Neamţ county. Archaeological diggings unearthing important items and artefacts of the Aeneolithic as well as objects dating back to the Neolithic Period and the Bronze Age make up many modern museum collections.
Excavations made outside the city reveal the ruins of a large Dacian city named Petrodava. Historians believe this to be the location of the Kingdom of Dicomes - in the very political centre at Petrodava. The complex of strongholds is unmatched in neither Moldavia nor Wallachia and are evidence of a powerful political and military centre both in Burebista’s time and in the period that preceded the reign of Decebalus.
The first urban settlements, which emerged under Petru I Musat during the period between 1375 and 1391, were Piatra lui Craciun, Roman and Neamț. The Neamț citadel, first mentioned in written documents dating back to February 1395, was also erected during the same consolidation period of the Moldovian principality east of the Carpathians. The Princely Court of Piatra Neamț is mentioned for the first time in a document dated on 20 April 1491, under Stephen the Great. The Princely Cathedral was built in 1497-1498, and the 20 m tall Bell Tower in 1499.