The village of Pathhead runs along either side of the A68 main road as it climbs up the hillside on the south side of the Tyne Water. This is a village which both geographically and historically has been defined by the road running through it. Two thousand years ago, the road was known as Dere Street, and linked the Roman town of Corbridge on Hadrian's Wall with their fortress at Inveresk, in today's Musselburgh. At that point the road did not bridge the Tyne Water, it crossed it at a point a little to the west of the bridge in the hamlet that became called, for obvious reasons, Ford.

Pathhead grew dramatically after a linen mill was built on the Tyne Water in 1738. By the late 1700s Pathhead had grown to become a straggle of single storey thatched cottages lining both sides of the main road for a significant distance up the hill side. It gained a post office in the early 1800s.

The Lothian Bridge was built over the Tyne Water by Thomas Telford in 1831 as part of the improvement in communication in Scotland. Telford was engaged by the Post Office to improve the road between Edinburgh and London. His survey led to a recommendation for a new road 362 miles long, compared with the 392 miles of the then existing Great North Road.

This bridge, or more strictly viaduct, has five semi-circular arches of 15.25 m. span and 15 m. high piers. It is an important example of how roads were improved to enable coaches to operate at twice their previous speed, from 5 to 10 mph. At the time, this reduction by half in time of travel was similar to that achieved by the motorway 130 years later. By 1836 there were over 100 mail coach services in Britain served by some 700 coaches. Further improvement in the road system was halted by the arrival of railways.

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