For most of the 19th and early 20th century Prestwich was known across England for one institution: the asylum. Prestwich Hospital was built in 1851 to handle the burgeoning psychiatric caseload of an industrialising Manchester, and by 1900 it had grown to be the largest asylum in Europe — a small town in its own right, with farm, laundry, chapel, water tower, mortuary and acres of recreation ground. Conditions there became the subject of an early exposé in 1921, when Montagu Lomax published The Experiences of an Asylum Doctor, an account of what he had seen during his time on the wards between 1917 and 1919. Lomax's book contributed to national reforms in mental health legislation. The hospital still operates, scaled down and reorganised, on the original site between Bury New Road and Heaton Park.

Prestwich is one of the centres of British Jewish life outside London. The migration began in the late 19th century from Cheetham Hill in Manchester and Broughton Park in Salford; the Holy Law Synagogue of 1934 was, according to Pevsner, the first purpose-built synagogue in Prestwich. With neighbouring Whitefield, Broughton and Crumpsall, it forms the second-largest Jewish community in the UK outside London. The Sedgley Park area has kosher restaurants and delis; the Jewish Telegraph has been produced and printed in Prestwich for decades. Around the religious geography sits the older fabric of an English parish town — St Mary the Virgin's Grade I listed church, the Anglican rectory, the Catholic Our Lady of Grace, and two Methodist chapels — with mosques added over recent decades to serve newer arrivals. The result is a town where the religious calendar runs on several overlapping timetables, and the high street's bagel shops sit next to vegan cafés and pubs run by Joseph Holt's brewery.

For a town of about 31,500, Prestwich has an absurd cultural CV. Victoria Wood — the comedian, actress and writer who shaped a generation of British comedy — grew up here. Mark E. Smith of The Fall, the post-punk band that became Manchester's most uncompromising musical institution, lived in Prestwich most of his life. Guy Garvey of Elbow still lives locally. Half of 10cc — Kevin Godley and Lol Creme — were born and raised here, and bandmate Vic Emerson too. Elkie Brooks, the blues and jazz singer. Howard Jacobson, the Man Booker Prize-winning novelist. Arlene Phillips, the choreographer and Strictly judge. Celia Birtwell, the textile designer and David Hockney's muse. Jenny Frost of Atomic Kitten. The novelist Emma Jane Unsworth. The singer Liam Frost. There is something about Prestwich — perhaps the proximity to central Manchester, perhaps the slightly more affordable rents that kept artists here when the centre got expensive — that has made it disproportionately fertile.

Two great green spaces sit beside Prestwich. Heaton Park, transferred to the City of Manchester in 1902, is one of the largest municipal parks in Europe at over 600 acres, with a Grade I listed Heaton Hall at its centre and a tram terminus that connects directly into the Metrolink network. Prestwich Clough, given to the Urban District Council in 1906 and now part of the 200-hectare Prestwich Forest Park, is a wooded ravine system descending toward the River Irwell — a Site of Biological Importance, threaded with the Irwell Sculpture Trail and a National Cycle Route. Both spaces were industrial land once; both have been reclaimed for walking, cycling and the simple business of getting out of the rain when it stops. The renovated Philips Park Barn now serves as an environmental education centre for the borough.

Prestwich sits on the Manchester Metrolink line from central Manchester to Bury, with four tram stops within the town: Besses o' th' Barn at the Whitefield border, Prestwich in the centre of the village, Heaton Park to the east, and Bowker Vale to the south-east near the Blackley border. The metrolink line was originally a Lancashire and Yorkshire Railway route, built in 1879 — converted to light rail in the 1990s when Manchester became one of the first British cities to bring its trams back. Bury New Road remains the spine of the town: high-frequency buses connect Manchester to Bury via the village, with The Witch Way express service running on through to Burnley and Pendle. The original road was turnpiked in 1826, but the route it follows is far older — those Roman boots passed this way two millennia ago.