Historical sources refer to the city as Poei, locating it near the site of the City of Metelis, a name dating back to Pharaonic times. Fuwa began to acquire regional importance when Christianity arrived in the area, and with it, the city became an Episcopal Seat. It was later mentioned in accounts of the Arab conquest of and in a letter 'Amr Ibn al-'As wrote to Caliph 'Umar Ibn al-Khattab informing him of the conquest of Maryut (Mareotis), Alexandria, Rosetta, Fuwa, Damanhur, Beheira and Damietta.

From the beginning of the 5th/11th century, Fuwa was the main city in the region of al-Muzahamatin, nowadays the province of Kafr al-Shaykh, covering the area between the region of al-Beheira and al-Gharbiyya. Along with al-Muzahamatin, Fuwa made up one of the iqta'at (singular iqta'), or land endowments given by Salah al-Din al-Ayyubi to his nephew al-Muzaffar Taqi al-Din and the town formed the second line of defence for Alexandria, Rosetta and Damietta on the coast.

In the Mamluk era, the Alexandrian canal was dredged twice, first by Sultan al-Nasir Muhammad and later by Sultan Barsbay, facilitating the development of agriculture and trade. Fuwa became an important trade centre and many European ships docked in her port on their way East through the Alexandrian canal.