Although it apparently did not appear in print until 1900 when it was used in a New York newspaper, the word "hillbilly" had been in use at least in the American backcountry for decades before that. The New York reporter said he heard the word in Alabama, but he could have heard it virtually anywhere across the rural South.

Certainly, the term goes back more than a century in West Virginia. A photograph taken in 1899, a year before the word's appearance in print in New York, shows a large group of white people with three black servants out for an elaborate picnic in a wooded setting in Greenbrier County. These prosperous people from Lewisburg most certainly knew the word hillbilly as a designation for social inferiors, yet someone of this group boldly hand-labeled the photograph "Camp Hillbilly," a voluntary association with a despised identity, a friendly jab at roughing it, and a sort of brag.

The word opens the cabinet of paradoxes about American social-class dynamics. Since the "billy" in hillbilly comes from Scots and means a companion, a comrade, and was generally used with affection and familiarity, it is possible that hillbilly first sprouted from the mouths of the very rural poor it was later used against. Like other pejoratives, in the context of social equals the word can be a friendly leveling device; but if offered belligerently or condescendingly or in contexts of unequal social status, it can start a fistfight.

The word hillbilly entered the urban American mainstream rather slowly. In 1915, it appeared in the title of a Harper's Monthly travel article ("Hobnobbing with Hillbillies") and also in a movie title, Billie-The Hill Billy, set in the Ozarks. But the application of the word to recorded commercial country music in 1923—24 greatly accelerated usage and added a non-threatening and even comic element to the meaning of hillbilly.

Hillbilly achieved a kind of chic in the economically destabilized 1930s when music promoter Glen Rice claimed to have found aboriginal country musicians in the wilds of the Santa Monica Mountains. He dubbed them "The Beverly Hillbillies," a radio musical group whose name preceded the popular 1960s television-series title. Hillbilly was becoming synonymous with "authentic" rural Americana isolated from the urban mainstream.

What seems laughable to the urban onlooker can also turn dangerous. The sinister threat in imaginary rural isolation came to fruition in the 1970 James Dickey novel and 1972 Hollywood movie, Deliverance, which featured the invasion of a rural stronghold by insensitive suburbanites. Deliverance's suggestion of the hillbilly's violent hostility against urbanites has successfully driven out earlier meanings. Since 1972, hillbilly often means warped by cultural isolation.

Whatever its connotations, it seems likely that the word will remain in wide circulation among West Virginians. In recent times, it has been applied to a much loved newspaper, the West Virginia Hillbilly, founded by Jim Comstock, and to the Man High School sports teams in Logan County.