The patron saint of Sesto Fiorentino is Saint Martin of Tours, celebrated on 11 November in the parish church that bears his name, among the first churches to arise in the town in the late Middle Ages. The Sesto territory was long a fief of the Florentine bishops, whom the population refused to pay burdensome tolls, suffering excommunication as a result; it later became part of the Florentine Republic, as capital of one of the leagues of the surrounding countryside, seeing notable development during the Renaissance thanks to the drainage of the plain.
In 1735 Marquis Carlo Ginori founded the Doccia Manufactory, one of the first porcelain factories in all of Europe, bringing significant economic development to the town: the Doccia Porcelain Museum still recounts its history today, while the town's State Art Institute descends from the school founded in 1873 by Marquis Lorenzo Ginori Lisci to train the craftsmen employed at the manufactory. Sesto was also at the centre of the late-19th-century workers' struggles, and in the 1860 referendum almost all voters declared themselves in favour of annexation to the Kingdom of Sardinia, which the following year would become the Kingdom of Italy.