Originally, Port Hood Island was connected to Cape Breton Island by a sand spit. It housed a booming lobster cannery, however, during a winter storm in the late 19th century, the thin sand spit connecting Port Hood Island was washed away. In the late 1950s, a road was constructed from the (then) main fishing wharf of the mainland to the fishing wharf on the island but it did not stand up to the weather and washed away shortly after completion. Rocks that made up the road still remain and now form what residents call the "Breakwater".
The island was originally settled by Protestant Loyalists, giving contrast to the Catholic majority in the Port Hood area. In the 1950s Port Hood Island had approximately 28 families, mostly fishermen and small lot farmers, along with a one-room school which handled grades 1-8/9, after which students boarded in Port Hood and attended Port Hood Academy. The island church enjoyed the services of the Port Hood minister who also served Mabou.
Currently the island is mainly lived on during the summer months, with about half the residents having prior connections to the area. One of the previous permanent residents died in the summer of 2003, and there are now only two people living on Port Hood Island all year long.
