Neolithic to Saxon finds from along the River Ribble during the creation of the Preston Docks and other revealed man has been in the area for a long time. The River Ribble looked completely different then and the coastline is likely to have been much further inland than it is at present where land has been reclaimed and the marsh extended out into the River Ribble due to sedimentation.
The Ribble would appear to have been known in Roman times as the Belisama, possibly giving its name to Samlesbury. Ptolemy's "Belisama aest." seems to represent the estuary of the Ribble. Bremetennacum was a Roman fort that guarded a crossing-point of the river at Ribchester. Remains of another Roman site were discovered at Walton-le-Dale in the mid 19th century.
The medieval silver Mitton Hoard was found near where this river joins the River Hodder in 2009. Whilst the Cuerdale Hoard, the largest Viking silver hoard ever found outside Russia was discovered in 1840 on the southern bank of a bend of the river, at Cuerdale near Preston.
At one time the Ribble marked the northernmost extent of the ancient kingdom of Mercia. At the time of the Domesday Book, the river formed the northern boundary of an area of land (known as Inter Ripam et Mersam) that was included in the Domesday information for Cheshire, though it was probably not formally part of the county of Cheshire.