Patti's origin is the decline of somewhere else. Tyndaris was founded on the promontory in 396 BC by Dionysius the Elder of Syracuse, and lived on as a Greek, Roman and later Saracen-era centre. As it faded, the settlement on the hill behind grew. The older name for the site is Epacten , from the Greek for on the bank or among the waters , and Sikel and Ausonian occupation is recorded there from the thirteenth and twelfth centuries BC.

The Roman period left something remarkable in the comune's own territory. The Villa Romana di Patti is a late imperial residence of roughly twenty thousand square metres, built in the fourth century AD over the remains of a villa of the second or third, with a peristyle court, an apsed hall, baths and polychrome floor mosaics. It was found by accident in 1973 , during construction of a stretch of motorway.

The medieval town begins with the Normans. In 1094 the Great Count Roger d'Altavilla founded the Benedictine monastery of the Santissimo Salvatore here. In 1131 the diocese of Patti and Lipari was erected; the two sees separated in 1399 .

And then the episode the town is known for. Adelasia del Vasto , widow of Count Roger I and mother of Roger II , the first king of Sicily, retired to Patti after her disastrous marriage to Baldwin I of Jerusalem. She died here in 1118 and was buried, by her own wish, in a chapel of the monastery. Her remains now lie in the cathedral in a Renaissance sarcophagus of 1557 .

The basilica cathedral of San Bartolomeo is the town's centre in every sense. Its present fabric is largely eighteenth-century, but a fine Norman portal has been remounted on the main facade, its clustered colonnettes carrying late Romanesque capitals with winged, two-faced zoomorphic and human figures. Inside are the chapel of Santa Febronia of 1760 , an organ of 1758 , a wooden crucifix of the sixteenth century in an eighteenth-century reliquary, a marble Virgin and Child of about 1500 by Antonio Vanella of Carrara, and an Adoration of the Shepherds attributed to the Flemish painter Guglielmo Borremans (1725).

Beside it stand the bishop's palace and the seminary — an administrative complex disproportionate to the town's size, and the reason so much of the region's church record passes through here.