The Shenandoah Valley is a geographic valley and cultural region of western Virginia and the Eastern Panhandle of West Virginia in the United States. The valley is bounded to the east by the Blue Ridge Mountains, to the west by the eastern front of the Ridge-and-Valley Appalachians (excluding Massanutten Mountain), to the north by the Potomac River and to the south by the James River. The cultural region covers a larger area that includes all of the valley plus the Virginia highlands to the west, and the Roanoke Valley to the south. It is physiographically located within the Ridge and Valley province and is a portion of the Great Appalachian Valley.

People began to utilize the Valley as the last great glaciers began their slow retreat to the Arctic beginning about ten thousand years ago. About 6500 years ago, the climate and landforms began to take on their modern characteristics, with mixed forests along the Blue Ridge and the Allegheny Plateau to the west, a mixture of meadows and occasional marshes on the Valley Floor. This is probably when a system of paths began to develop. Extensive use of seasonally abundant foods permitted more people to live in the area and semi permanent villages began to appear.

After 900 AD, native life in the Valley and the surrounding region took on an important new dimension with the adoption of domesticated plants, notably corn, beans and squash. This contributed to local landscapes as villagers began to clear and maintain planting fields.

The importance of agriculture lies in a growing number of sedentary village communities, the remains of which offer insight into social and cultural development that, in turn, suggests how the Great Path and its tributaries were used.

We know far less about who engaged in settlement, trade, and intrusion than what they did. By the time colonists set foot in the Valley, most of its native inhabitants had long since departed. What these villagers called themselves, what language(s) they spoke, are now lost.

The following Native Tribes are thought to have been active in the Middletown area. The Piedmont Siouans, Catawbas, Shawnee, Delaware, Cherokees, Susquehannocks and the Iroquois. The Iroquois were the Six Nations tribe which included Mohawks, Oneidas, Onondagas, Cayugas, Senecas and later Tuscaroras.