The town is famous throughout Bulgaria for the fight that took place there in 1876 during the April Uprising against the Ottoman reign. During the suppression of the uprising by Turkish irregulars, the majority of the residents were slaughtered. The French journalist Ivan de Woestyne, who visited the town in July 1876, reported for the newspaper Le Figaro that out of a population of about 2000 only 150 elders and children were left.Lady Strangford arrived from Britain later that year with relief for the people of Bulgaria following the massacres. She first built a hospital at Batak and eventually other hospitals were built including one here at Perushtitsa.
The name Perushtitsa comes from the word Peristitsa, which in turn comes from the name of the God Perun.
Perushtitsa is one of the few places in Bulgaria where Mavrud grapes are grown for a typical Bulgarian wine Mavrud.
About 2 kilometers south of Perushtitsa is the Red Church. The remains of the Red Church date from the 5th or 6th century and are a symbol for the city of Perushtitsa.