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Middletown is a borough in Dauphin County, Pennsylvania, on the Susquehanna River, 10 mile (16 km) southeast of Harrisburg. As of the 2020 census, it had a population of 9,550. It is part of the Harrisburg–Carlisle Metropolitan Statistical Area.

Middletown was founded in 1755 along the left bank of the Susquehanna River and was incorporated as a borough in 1828 after a sudden boom in development and population occurred as a result of the construction of the Union Canal, connecting Lancaster to Middletown. In 1824, Pennsylvania's statelegislature authorized and funded the canal construction as part of the broad sweeping commercial initiative called the Main Line of Public Works; a forward looking project designing to connect Philadelphia to Pittsburgh by canals and river navigations and Philadelphia to challenge New York City and the Erie Canal for emerging mid western markets beyond the Allegheny Mountains. Middletown was selected as the western terminus of the Union Canal, and it was named from its location halfway between Lancaster and Carlisle, where an ascent exists to a low pass allowing easier wagon era travel among the barrier mountains of the Ridge and valley Appalachians giving access into north central Maryland and the valley of the Potomac River. It is the oldest incorporated community in Dauphin County and is located within a rich agricultural area forming the western edge of Pennsylvania Dutch Country.

The George Everhart (Frey) Trust, named for a citizen of Middletown from the 1800s, still manages leases on much of the land in and around Middletown. The trust was founded to operate the Frey Orphanage and did so for many years, in three locations in Middletown. The orphanage eventually closed, and the final location, on Red Hill, has become the , a Diakon Lutheran senior living facility.

Middletown is located 3 miles (5 km) north of the Three Mile Island Nuclear Power Plant. The Unit #2 reactor at the Three Mile Island Nuclear Power Plant suffered a partial meltdown in 1979, causing then Pennsylvania governor Dick Thornburgh to order the evacuation of pregnant women and pre school children from the area. Within days, 140,000 people had left the area. President Jimmy Carter visited Middletown's Community Building to calm the nerves of anxious residents. Because the town is old, diverse historic architectural styles abound. Middletown has everything from log houses, some whose construction is obscured by modern siding, to Victorian mansions, and beyond. The Simon Cameron House and Bank, B'nai Jacob Synagogue, St. Peter's Kierch, Charles and Joseph Raymond Houses, Henry Smith Farm, and Swatara Ferry House are listed on the National Register of Historic Places.

Middletown is located in southern Dauphin County at (40.198491, 76.729326). Its southern border is along the Susquehanna River, and its eastern border is formed by Swatara Creek, across which is the borough of Royalton. Pennsylvania Route 230 (Main Street) leads northwest 10 mile (16 km) to the center of Harrisburg and southeast 8 mile (13 km) to Elizabethtown. Via the PA 283 expressway it is 28 mile (45 km) southeast to Lancaster. The Pennsylvania Turnpike (Interstate 76) passes through the northern part of the borough, but the nearest access is 4 mile (6 km) west near Highspire. According to the U. S. Census Bureau, the borough has a total area of , of which is land and , or 2.33%, is water.

As of the census of 2000, there were 9,242 people, 4,032 households, and 2,370 families residing in the borough. The population density was There were 4,387 housing units at an average density of The racial makeup of the borough was 88.77% White, 7.34% African American, 0.27% Native American, 0.53% Asian, 0.04% Pacific Islander, 0.92% from other races, and 2.13% from two or more races. Hispanic or Latino of any race were 3.18% of the population. There were 4,032 households, out of which 28.2% had children under the age of 18 living with them, 40.8% were married couples living together, 13.9% had a female householder with no husband present, and 41.2% were non families. 35.2% of all households were made up of individuals, and 14.2% had someone living alone who was 65 years of age or older. The average household size was 2.23 and the average family size was 2.90. In the borough the population was spread out, with 23.0% under the age of 18, 8.5% from 18 to 24, 30.1% from 25 to 44, 21.1% from 45 to 64, and 17.3% who were 65 years of age or older. The median age was 37 years. For every 100 females, there were 84.9 males. For every 100 females age 18 and over, there were 80.5 males. The median income for a household in the borough was $35,425, and the median income for a family was $43,661. Males had a median income of $32,891 versus $24,692 for females. The per capita income for the borough was $18,535. About 4.6% of families and 6.6% of the population were below the poverty line, including 6.6% of those under age 18 and 5.6% of those age 65 or over.

The Middletown Area Historical Society Annual Arts and Craft Fair. Located in Hoffer Park the first Saturday in June. Trick or Treat – the Thursday closest (before) Halloween is the night used for the annual Trick or Treat. Houses with their porchlight on from 6 pm until 8 pm are houses participating.

The Middletown Area Historical Society is both a museum and visitor center located at 29 East Main Street. Indian Echo Caverns, located 5 miles north of the borough limits, is one of the main attractions near Middletown. The caverns were originally used by the Susquehannock tribe, who lived and hunted in the nearby area until their population and authority was quickly decimated by the spread of infectious disease in the late 1670s, leading to their absorption by neighboring tribes. It opened to the public in 1929. The shortline Middletown and Hummelstown Railroad operates heritage and freight service between its namesake towns of Middletown and just south of Hummelstown proper, stopping in front of the Indian Echo Caverns entrance.

In the town there is an American Legion, a borough office building, and a post office. The legion (located at the intersection of High and Spruce Streets) and the post office is located on Main Street. The borough office building is located on West Emaus Street. The town also has several churches. The Middletown Volunteer Fire Department occasionally serves as a distribution center for Potassium Iodide pills supplied by the Pennsylvania Department of Health. Middletown falls within a 10 mile radius of Three Mile Island.