Kuantan in the first century was a part of Chih-Tu empire. In the 11th century, this piece of land was conquered by another small empire called Pheng-Kheng before being taken over by the Siamese during 12th century. During the 15th century, Kuantan was ruled by the Malacca Empire.
Kuantan is said to have been founded in the 1850s. The word "Kuantan" was mentioned by Abdullah bin Abdul Kadir (Munshi Abdullah) circa 1851/2 as below:
On Thursday night came a boat from Kuantan. Then they told the ship's crew there's a pirate ship at
Tanjung Tujuh, forty of them and at Pulau Kapas, and as well at Pulau Redang; it was spotted by two Kuantan boats and they set off... ”
In its early days, it was known as Kampung Teruntum (Teruntum Village). The village was situated at the mouth of Teruntum River which is in front of the current hospital and it was established by Haji Senik and his followers in the 1850s. Early primary economic activities included fishing and small businesses. The main evidence of the establishment of the village is the cemetery that is situated near Taman Esplanade in front of the current Hospital Tengku Ampuan Afzan.
Towards the late 19th century, arrival of Chinese miners and traders saw the establishment of a township in Kuantan and also nearby tin mining areas such as Gambang and Sungai Lembing. Similar to what occurred in other states in Peninsular Malaysia, rubber plantations attracted Indian settlers as well.
The sinking of HMS Prince of Wales and HMS Repulse took place off the coast of Kuantan on 10 December 1941
