The department was first formed in 1917 at the time the city was incorporated into a village, as a group of volunteers. They were equipped with 1 tub, 12 buckets, 1 extension ladder and 1 ax. Fire alarms were sounded by using a bell in the Methodist Church.

In September 1919 the department was reorganized by a group of citizens headed by the first Fire Chief, D.B. Smith. The department first purchased a 100 gallon fire extinguisher mounted on wheels, which had to be pulled by manpower. Land was purchased where the North College Hill Tailor Shop now stands. Equipment was housed in the basement and a bell bought and mounted in the tower in 1920.

As the village grew the firemen started looked for more apparatus. In 1920 they purchased a 1917 model T Ford Pumper from Ft. Thomas, KY for the huge sum of $500. This was the first piece of motorized fire equipment on the hilltop.

By 1924 the village was growing fast and additional equipment was needed. A new 1924 Reo Fire Truck was purchased for $5,000. This money was borrowed from the First National Bank of Mt. Healthy. Four firemen, T. Weber, W.D. Smith, E. Knollman and J.C. Conway used their homes as collateral to secure the loan. This was the start of the firemen's carnivals which raised money to pay off the loan.

In 1926 the Fire Department was incorporated. The in 1931 the Village Hall and Firehouse were constructed. The 1924 Reo Fire Truck was sold to the Village of North College Hill for $1. As the village grew into the City of North College Hill, additional equipment was purchased with city bond issues and money from the carnivals.

In 1946 the firemen formed a Life Squad. A 1942 Packard Ambulance was purchased and equipped. The firemen were trained and the department began making life saving runs. This was one of the first Life Squads in the area.

In 1992 the department struggling to find volunteers available to respond to emergencies during the day began a part-time firefighter program which provided two firefighter/EMT's during from 6am until 5pm. 

In 2002 facing a critical shortage of volunteers and increased demand for service, the department moved from mixed part-time and volunteer staff to an all part-time staff consisting on four firefighter/EMT's on duty twenty-four hours a day, seven days a week. 

By 2012 the need for improved emergency medical service capability necessitated the addition of paramedic level service which continues today.