It initially grew around the wool combing industry, until the onset of the plague, which swept the town from 1663 to 1665. To prevent the spread of the disease, the town was chained at either end, which succeeded in its task but at the cost of two-thirds of the populace. The town did not recover for nearly two hundred years, with the canalisation of the River Gipping in the late 18th Century and the introduction of the railway. Modern Needham Market contains two road names that are linked to the plague. Chainhouse Road, named after the chains that ran across the East end of the town. The Causeway, is a modern variation of 'the corpseway' so called because of the route that plague victims were transported out of town, to neighbouring Barking church for interment.
The village contains many businesses; a post office and stationers, hairdressers, Bretts Bakery, Smiths Butchers, Pauls Hardware shop and many more.
Notable buildings in the town include:
The town is on the route of the Dunwich Dynamo annual cycle ride.
Needham Lake (a former gravel pit) provides leisure facilities and a wildlife habitat.
The East Anglia Main Line railway runs through the town, with Needham Market railway station providing trains to Ipswich and Cambridge. The A14 (although then the A45) once ran directly through Needham Market, but a bypass was built in the 1970s. This has left the town with good road links to the surrounding area, but with less traffic than before.
Notable people from Needham include:
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