Scottish and Scotch-Irish emigrants first brought Presbyterianism to Virginia and the Carolinas in the early eighteenth century. Like other Reformed bodies, Presbyterians are indebted to both Calvinism and ecclesial polity, the former a theology of human depravity, atonement, and grace, the latter an inherited presbytery system of governance from which the denomination derives its name. Presbyterians were active participants in the First Great Awakening, a series of protracted meetings in the 1730s–1740s that exposed an enduring rift between “Old Side” and “New Side” factions over revivals’ growing influence and popularity. “New Side” Presbyterians grew in numbers as the revivals they favored flourished, with Kentucky’s pro-revival Cumberland Presbyterian Church established in 1810. Presbyterians would revisit this issue again in a second schism dating from the 1830s–1870s.

Throughout their history, Presbyterian bodies have worshipped in the anti-formalist, non-liturgical continental Reformed tradition, preferring the use of biblical psalms and canticles and supporting a vibrant tradition of metrical psalmody long after other denominations turned to non-biblical texts. Even hymnals issued by the liberal Presbyterian Committee of Publication in Richmond, Virginia, incorporated a substantial repertoire of metrical psalmody, like the 1882 Psalms and Hymns and Spiritual Songs. While denominational hymnals and tunebooks emerged by the 1860s, many congregations continued to sing from the 1650 Scottish Psalter, aided by the lining-out of a precentor. As recently as 2018, the Orthodox Presbyterian Church published "The Trinity Psalter Hymnal" in conjunction with the United Reformed Churches in America.

—Erin Fulton