San Severino has changed altitude twice. Down on the plain, along the Potenza, stood Roman Septempeda, which fell into ruin in the early Middle Ages; then the people climbed the hill called Monte Nero and renamed the city after a local saint, Severinus, bishop of Septempeda in the middle of the sixth century, of whom very little is known. Later, when defence was no longer needed, the settlement came back down almost entirely to the valley floor, around the old market square; and between the middle of the eighteenth century and the beginning of the nineteenth the symbols of power went too, the town hall, the cathedral and the bishop's seat, leaving an isolated quarter up there. The coat of arms, recognised in 1961, nevertheless shows the façade of the old cathedral, the one left on the hill: the city carries on its shield the building it abandoned.
The territory is the largest in its province, and it keeps things far older than the name. At Pitino excavations have brought to light a Picene settlement on a hilltop and three necropoleis between the seventh and the fifth century before Christ; of the Roman city there remain walls, baths and a kiln, and some inscriptions speak of a temple dedicated to Feronia, a Sabine divinity to whom freedmen were consecrated. A legend had it that Septempeda was destroyed by Totila during the Gothic war, but the evidence says the old city went on living throughout the late Middle Ages, and the legend falls. In the fourteenth century the lordship belonged to the Smeducci, soldiers of fortune disliked by the population, which rebelled more than once and saw them exiled by the pope in 1426: and yet theirs was the period of the city's greatest artistic flowering. In 1586 San Severino obtained the title of city and a diocese, which it held for exactly four hundred years. The earthquakes of October 2016 made a great many houses uninhabitable.