Royston got its start where two ancient thoroughfares crossed, the Icknield Way (which became Ashwell Street) and Ermine Street. Ermine Street was constructed after a Roman conquest while the other street is a routeway that dates back to prehistoric times. They were considered military Roads because they were used by Roman soldiers to travel to Britain. A cross was erected where the roads intersect but when is unknown. The cross is know by three various names, Rohesia's, Royse's or Rosisia's Crosss. It was from the cross that the settlement got the earliest of its name, Crux Roesia which means Roisia's Cross. It was finally called Royston in the 14th century but first was know as Roisia's Town and Roiston.

Royston was divided into five separate parishes, Reed, Barkway, Therfield in Hertfordshire, Kneesworth in Cambridgeshire and Melbourn. This was until 1540 when the entire area became its own ecclesiastical parish. In 1200 the Hospital of St. Nicholas was founded by the daughter of Richard the Chamberline, Amphelise, on the Cambridgeshire side of the town. In 1224 there were two hospitals established to treat lepers, St. John and St. Thomas. They were founded by the Sheriff of Cambridgeshire, Richard Argentine, on Baldock Street's south side.

James VI of Scotland, traveling with King James I of England, stayed in the town on April 29, 1603 at the Chester residence. James VI later rented the home for a year because of the good hunting in the area. In 1604 he demolished the Cock and Greyhound Inns to make a hunting lodge. The lodging for the kind was done in 1607. While it was not suitable for a full court, it gave the kind the perfect place to stay while hunting near London. He also restricted the hunting by anyone else with in 16 miles of the town and created an infrastructure that was elaborate to support the pursuit of his sport. Charles I, who succeeded James visited the town less often. Though he was brought through the town while being held as one of the Parliamentary army's prisoners. After he died the royal building began to fall apart and the interest the Crown had in the town was sold in 1866.

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