Molokai was formed by volcanic activity some one and a half million years ago. Two large volcanoes pushed through the surface of the Pacific Ocean to create this island, with Kamakou in the east and Maunaloa in the west. The Makanalua peninsula was formed on the north side shortly after. Over time, the north side of the island eroded away, resulting in the vertical sea cliffs that comprise today’s North Shore 

Hawaiians first inhabited Molokai in 650 AD, most likely coming from the Marquesas, and later from Tahiti and other South Pacific locations. The first-known Hawaiian settlement was in Halawa Valley on the eastern side of the island. People were probably drawn to the ample mountain water, fertile land, and proximity to the ocean.

In 1778, Captain James Cook first sighted Molokai on a visit to the Sandwich Islands. And in 1786, the first Europeans arrived when Captain George Dixon anchored off the coast of Molokai .

In 1832, a Protestant mission was established at Kalua’aha on the east end of the island by Reverend Harvey Hitchcock. The church is served a population of about 5,000, and parts of the building's walls and roof still stand today.

In the mid-1800s, Chinese laborers arrived to work the sugar cane fields. Apparently they carried in leprosy (Hansen’s Disease), which spread to many Hawaiians, who called the disease Ma’i Pake (Chinese sickness). With no cure available, strict isolation was required of those afflicted. In 1866, sufferers were rounded up and left on Kalaupapa on the north side of the island.