The county was created by the Massachusetts General Court on May 10, 1643, when it was ordered “that the whole plantation within this jurisdiction be divided into four shires”. Middlesex initially contained Charlestown, Cambridge, Watertown, Sudbury, Concord, Woburn, Medford, Wayland, and Reading. In the late 19th century and early 20th century, Boston annexed several adjacent cities and towns including Charlestown and Brighton from Middlesex County, resulting in an enlargement of Suffolk County.
Most municipalities in Middlesex County have a town form of government
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