The Romans abandoned the Lower Rhine eventually, and Neuss settled into the slow centuries of the early Middle Ages as a river town with a ferry and a harbor. What transformed it was a saint. In the 10th century, the relics of the Roman martyr Quirinus - a tribune, not the obscure Roman god of the same name - were translated to Neuss. Within a generation the town was on every pilgrim's itinerary, drawing the faithful from beyond the Holy Roman Empire's borders. The Basilica of St. Quirinus, begun in the 13th century in the late Romanesque style and elevated to minor basilica in 2009, still rises over the old town with its distinctive dome-shaped eastern tower. The annual Schutzenfest, held on the last weekend of August, descends in part from the medieval guilds that organized to defend the pilgrim trade. Roughly 7,000 marksmen in traditional uniform parade through the city. It is one of the largest such festivals anywhere in Germany.

On 29 July 1474, Charles the Bold, Duke of Burgundy, parked his army outside Neuss and refused to leave. He had the men, the artillery, and the ambition to extend his Burgundian state into the Rhineland. He did not have the patience for what the citizens of Neuss were about to do to him. The siege lasted nearly a full year. The town walls held. The citizens ate what they could find. Emperor Frederick III eventually mustered an Imperial army to relieve the city, and Charles withdrew in June 1475 without taking it. The reward was substantial: the right to mint coins, the imperial eagle and crown added to the city's coat of arms, membership in the Hanseatic League (which never quite accepted Neuss as a real member, but the title sounded good). Charles the Bold died less than two years later at the Battle of Nancy. Neuss is still there.

In 1586, more than two-thirds of the city burned. The wars of Louis XIV battered the regional economy through the late 17th century. Neuss spent the better part of two hundred years as an agricultural backwater. Napoleon's France absorbed it from 1794 to 1814; the Kingdom of Prussia took over after Waterloo, reorganizing Neuss as a district seat with a population of just 6,333. What turned the city around was the 19th century - specifically, the expansion of the Rhine harbor in 1835 and the arrival of industry. By 1881 the boundaries had been redrawn to accommodate growth. By the 20th century, Neuss had reattached itself to the Rhine-Ruhr economic engine, and today it serves as the European headquarters of Toshiba and the seat of the Rhein-Kreis Neuss district government, with about 440,000 people in the surrounding region.

Documentation of Jewish life in Neuss begins in 1096, when Jews fleeing Cologne during the People's Crusade were sheltered here by the Archbishop. Roughly 200 were murdered anyway. The Rhineland massacres are not a footnote - they are a foundational trauma of European Jewish history, and Neuss is in them. An organized Jewish community is firmly attested from the late 12th century. In 1694 Jews received the right to hold a cattle market in front of the Obertor. The Nazi regime murdered at least 204 Jews with ties to Neuss, whose names are listed on a monument by the sculptor Ulrich Ruckriem. Stolpersteine - small brass cobblestones inscribed with the names of victims - are set into sidewalks throughout the city, one in front of each last freely chosen home. Since the 1990s, the community has been slowly rebuilding, swelled by Jewish immigration from the former Soviet Union. About 550 Jews now live in Neuss.

The Obertor, built around 1200, is the only surviving gate of the original six in the medieval wall - today it houses part of the Clemens Sels Museum, which holds many of the Roman finds from Novaesium. The Blutturm (Bloody Tower) is the lone remaining round tower of the old fortifications. The pub Zum Schwatte Pad, the Black Horse, opened in 1604 and is reportedly the oldest tavern in the Lower Rhine region. And, in a touch that perfectly captures the city's habit of doing the unexpected, Neuss built a full-scale replica of the London Globe Theatre, which hosts an annual Shakespeare festival in English. Two millennia in, the city is still adding things.