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At its inception in 1770, Botetourt County, Virginia, included the Virginia counties of Fincastle, Greenbrier, Rockbridge, Montgomery, Bath, Monroe, Alleghany, Roanoke, and Craig, as well as parts of West Virginia, Ohio, Indiana, Illinois, and all of Kentucky. This region lay within the great Valley of Virginia and along an important migration route to Southwest Virginia, Kentucky, and North Carolina, a route taken, first, by Scotch-Irish pioneers and, following them, Palatine Germans and Huguenots.

Mrs. Prillaman's book focuses on the family and local history associated with such places within present-day Botetourt and Roanoke (created in 1838) counties as Amsterdam, Haymakertown, Catawba Creek, Greenfield Plantation, Trinity, North Roanoke, and Salem. Her coverage of schools, churches, and businesses is detailed, and the work is profusely illustrated with portraits of early settlers, important structures, cemeteries, and other landmarks, as well as maps, drawings, and facsimiles of records. Of greatest interest to the genealogist, however, are the histories of Valley of Virginia families, thousands of references to which may be found in the index at the conclusion of the book: Adams, Anderson, Baker, Bigler, Boitnott, Bolton, Bowman, Boxley, Breckinridge, Brogan, Brown, Brubaker, Bryan, Burton, Cloyd, Coffman, Coon, Dillard, Engel (Engle), Firebaugh, Frantz, Gish, Goodman, Gusler, Harshbarger, Hinman, Houston, Huff, Huffman, Ikenberry, Jamison, Kern, Kessler, Kinsey, Lambert, Layman, Linkenauger, McAfee, McDonald, Mangus, Murray, Nininger, Oliver, Painter, Patterson, Peffley, Preston, Ramsey, Richardson, Riley, Ronk, Sessler, Thomas, Tinnell, Walrond, and Watkins.