City National Bank was organized in Charleston in 1956 and opened its doors under President Donald Shonk in 1957. The new bank advertised that Muzak would be playing continuously for bank lobby patrons. In 1969, as another marketing innovation, City National introduced employee uniforms featuring bright green jackets, a practice which has since been discontinued.

As the bank prospered, a former bakery at the corner of 36th Street and MacCorkle Avenue in Charleston's Kanawha City neighborhood was purchased and extensively remodeled as bank headquarters. While the City National headquarters has since moved to suburban Cross Lanes, the Kanawha City facility remains the bank's main branch.

The bank's growth was reflected in its rapid rise in assets, $37.4 million by 1975 and over $81 million in 1982. In March 1984, after liberalization of West Virginia banking laws, City Holding Company was created to facilitate the bank's expansion. Over the next decade, City Holding acquired a number of other banks throughout West Virginia and radically diversified its business by buying Jarrett-Aim Communications (a printing company), as well as an insurance company and an Internet service, Citynet. This diversification strategy failed, and by late 2000 bank stock had fallen to a fraction of its former price. In that year, the top management was changed and the federal Office of the Comptroller of the Currency intervened to require changes in bank policy. New management decided to close some branches and divested the bank of a number of assets, including the printing and Internet businesses. By 2003, the bank was no longer under direct federal supervision and the stock value had largely recovered. In 2005, City National was the fifth-largest bank in West Virginia, with deposits of $1.7 billion.

By 2024, City National Bank had assets of $5.83 billion, making it the second-wealthiest West Virginia-based bank, behind WesBanco of Wheeling. City National had 57 branches in West Virginia, 16 in Kentucky, 14 in Virginia, and three in Ohio.