Gerome's Sausage Company began in the late 1800s in Ascoli Piceno, a town in the Marche region of Italy. The recipe was handed down from Perrino and Rosie Girolamo (Gerome) in the early 1900s.

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The original sausage was prepared from the meat of pigs raised at their farm in West Virginia. Eventually, the family moved to Bristol, Pennsylvania and started Gerome's Market in 1955 where Gerome's sausage was sold. The business was sold in 1985, but reopened in Fairless Hills in 2007. One day shy of its one-year aniversary, the store suffered a devastating fire and reopened at the current location in 2009 under the ownership of Michael Gerome who uses the original recipes to this day.

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