The St Ives settlement was developed by the monks of Ramsey Abbey who built the town's first bridge, a wooden structure, in 1107. In 1414 it was decided to replace this bridge with a stone arch bridge, which was completed in 1425, the chapel being added the following year.

During the English Civil War the bridge was partially blown up by the troops of Oliver Cromwell to prevent King Charles I's troops approaching London from the Royalist base in Lincolnshire. During the war, and for some period afterwards, the gap was covered with a drawbridge. When the bridge was rebuilt in 1716 the shape of the new arches at the southern end was in accordance with the style of the period, leaving the bridge with two rounded arches on its South side and two Gothic arches on the North. The bridge is only one carriage wide and in good order and is a particularly attractive sight in a charming small town.

The chapel was restored in 1930, after periods of use as a toll house, inn and as a private residence. By 1736 it was being used as accommodation, and in that year two extra floors were added. These remained until the early 20th century until removed as part of the restoration work and, as a result, the roof is modern. An unusual feature is the crypt which sits two metres above water level.

The bridge and the chapel are now Grade I Listed Buildings and a Scheduled Ancient Monument.

South of the bridge, the London Road proceeded across a swampy area on a causeway with piecemeal bridges built by various benefactors, from time to time and as the currents of the water shifted. In 1755 it became the responsibility of the Bury to Stratton Turnpike Trust. The condition was still unsatisfactory when the Trust was renewed by an Act of 1818. At this point firm action was taken and the causeway was totally rebuilt and opened in 1822. With an astonishing 55 arches, it is the longest road causeway - as well as having the largest number of brick arches - in the country.