The series was initially put into development by Starz in November 2017 under the working title 'P-Town' before being retitled 'Hightown' when it received a full series order in November 2018.

Creator Rebecca Cutter later signed a deal with Lionsgate Television following the show's development.

Rachel Morrison was announced as a director for the series in February 2019.

Monica Raymund was the first cast member announced, joining the pilot in a leading role in September 2018, followed by James Badge Dale and Riley Voelkel in January 2019, and Shane Harper, Atkins Estimond, Amaury Nolasco, and Dohn Norwood in February 2019.

Luis Guzmán joined the cast in a recurring role for the second season in November 2020, alongside other recurring cast additions like Crystal Lee Brown, Cecil Blutcher, Carlos Gomez, and Barbara Weetman announced in December 2020.

Principal photography for the first season took place in Provincetown, Massachusetts, with the local Select Board approving filming from May 20 to June 11, 2019, at locations including MacMillan Pier, the harbor, the West End rotary, and Provincetown Inn.

A portion of Commercial Street in Provincetown was closed on June 4, 2019, so the production could recreate a Carnival parade scene.

Starting with season two, production relocated from Provincetown, Massachusetts to Wilmington, North Carolina.

After being quietly removed from Starz following the end of the series in 2024, all three seasons of Hightown became available to stream on Netflix on July 23, 2025.