Nanhua, formerly known as "Nanzhuang," was located in a valley among lofty mountains at the source of Cailiao River, or the west slope of inner Mount Wushan to be precise. During the years when Emperor Yongzheng and Emperor Qianlong were in reign (1723-1795 A.D.), Han Chinese came to open up virgin soil and gradually formed villages, which were then designated by the Qing government as "Neixinhuananli," one of its territories. Xiaoluncun Village (restructured as Xiaolun Village), Fengshan Temple, Beipingcun Village (restructured as Beiping Village), and Matsu Temple were all built in the middle period of Emperor Qianlong's reign (around 1766 A.D.). During the 1796 to 1874 period, there was already a "Nanzhuang Street" in Neixinhuananli.
The district was administered under Ako Prefecture, Hozan Sub prefecture. Qing Dynasty, after being defeated in the Sino-Japanese War, signed the Treaty of Shimonoseki and ceded Taiwan and Penghu to Japan. Japan incorporated this district to Nanzhuang (Nan Jo), Nanzixianxijiaobanian Sub prefecture, Tainan Prefecture. In 1920, Japan abolished the Cho System and established Shus, Guns, and Jos, thereby modified Nan Jo to Nanhua Jo. After World War II, the name was again modified to become Nanhua Township, Tainan County in 1945. After the merger of Tainan County and City in 2010 and its becoming a municipality, it is now named Nanhua District of Tainan City.