When a library was first established in the Madison County community of Truro, books were added to a rental shelf and loaned to residents at a cost of 10 cents each. As money was raised through the rental fee, new books were purchased and added to the library collection. The library moved to the current building in 1966, which was expanded in 1978. The first computer was installed in the Truro Public Library in 1998, and interior renovations were completed in 2005.

Moving forward, the Truro Public Library has created a set of short- and long-term goals for operation, including growing the video library, maintain copy machine availability, update collections with new materials, and purchase a new computer every three years.