During the Crusades, the town was a barrier fortress of the Principality of Antioch. However, after the capture of Baldwin II of Edessa, the inhabitants of al-Fu'ah and nearby Maarrat Misrin and Sarmin revolted against their Crusader rulers in 1104, inflicting heavy casualties against their troops. The town was later captured by Fakhr al-Mulk Radwan in 1104. Alsunqur al-Bursuqi of Mosul occupied al-Fu'ah, along with Sarmin, in 1126. Al-Fu'ah was visited by Syrian geographer Yaqut al-Hamawi in the early 13th-century, during Ayyubid rule. He noted that it was a "large village in the neighborhood of Halab. From it the convent called Dair Fu'ah takes its name." He also mentioned that the people in the town and the surrounding area including Aleppo, followed Twelver Shi'ism or as he describes it "Imami". In the late 13th-century, the town was mentioned by Syrian geographer Abu'l-Fida, who described the town as a celebrated place in the plain of Aleppo. He noted that, "on this plain are grown quantities of olive, fig and other trees."
While most towns in the Idlib Governorate came under the control of anti-government rebels during the Syrian Civil War, al-Fu'ah and the nearby town of Kafriya constituted an isolated pro-government enclave. According to the Syrian Center for Documentation, in April 2012 rebels kidnapped eleven members of the Governmental Scientific Research Center in al-Fu'ah. In July 2012 a rebel unit kidnapped three Shia Muslim civilians from the town for the stated purpose of exchanging them for anti-aircraft weaponry. In response, some of al-Fu'ah's residents kidnapped 32 Sunni Muslims from nearby Taftanaz, Saraqib and Binnish. After two weeks of negotiations, all captives were safely released. On 18 September 2015, al-Fu'ah was badly damaged, following a suicide bombing with an armoured vehicle full of explosives from Uzbek-led militant group Imam Bukhari Jamaat, an affiliate of al-Qaeda. The town was placed under siege by rebels, and on 11 January 2016, the International Committee of the Red Cross and the World Food Programme organised an aid convoy to deliver food, medicine and other aid to the town and nearby village Kafriya. On 19 July 2018, residents of Fuah and Kafriya and pro-government fighters stationed in the two besieged towns were evacuated by buses to government-controlled Aleppo under an agreement between Iran, the Syrian Government, and Hayat Tahrir al-Sham, with Turkey as a mediator. Syrian Government released 1,500 HTS prisoners in exchange for the safe evacuation of these towns. Following the evacuation, the emptied towns were temporarily declared a military zone by HTS.
