Barnabas Hughes laid out a town and named it Elizabethtown in honor of his wife. The town, one of the earliest communities settled in Lancaster County, had a central square and "diamond" pattern common to many of the newly founded Pennsylvania towns. Stakes in the ground identified boundaries of the lots and of the streets and alleys in town. Barnabas Hughes gave them the names they still have today - Market Street, High Street, Rose Alley, Cherry Alley, and Peach Alley. Situated along a trail, which became the Lancaster-Harrisburg Turnpike, the trading and tavern business flourished and the town grew rapidly.

Elizabethtown was incorporated as a Borough on April 13, 1827.

Historians recognize Elizabeth and Barnabas Hughes as the founding family of Elizabethtown.

In preparation of the 175th anniversary of Elizabethtown's incorporation, residents of Elizabethtown researched the history of their community further and discovered that the Elizabethtown region shares many names with Ireland such as Donegal, Rapho, and Mount Joy to name a few.

Contact was established with the town of Letterkenny in County Donegal, Ireland, and it was soon realized that the two communities share much in common. Elizabethtown and Letterkenny are similar in size, both communities are college towns, they each have a candy company, both have active downtowns, among other similarities.

A sister city "Memorandum of Understanding" was signed in November 2002 by government officials of Elizabethtown and Letterkenny at a gala event celebrating Elizabethtown's 175th anniversary. This sister city agreement opens the door for exchanges between the two communities in areas to include government, business, service clubs, education, and other relationships to benefit both communities.