The area where Antsirabe is found today was part of the Kingdom of Andrantsay which existed from the early 1600s until it was incorporated into the Imerina kingdom in the early 1800s. The area was a farming region, with production of rice, vegetables and fruit.
The first Norwegian missionaries arrived in 1868. Limestone and sulphur were exploited in the area at this time.
The city was founded by Norwegian missionary T.G. Rosaas in 1872 as a hill station to serve as a retreat centre because of the much cooler climate. The thermal baths were opened in 1917.
In 1886 the Norwegian mission established the leper hospital of Ambohipiantrana and it quickly developed into a village for lepers. The colonial government decided to make it the leper hospital of Vakinankaratra and the around 950 people with the illness lived there in 1904.
During the French colonial rule the centre of the Vakinankaratra region shifted from the Andrantsay capital of Fivavahana to Antsirabe
