The lake is named for the Falls of the Neuse, a once whitewater section of the river that fell from the Piedmont into the lower Coastal Plain submerged during construction of the lake.
The lake provides drinking water for several of the surrounding communities, including the city of Raleigh, aids with flood control and serves as a recreation area and wildlife habitat.
Work on the dam that holds the lake began in 1978 and was completed in 1981. Prior to its construction flooding of the Neuse River caused extensive damage to public and private properties including roadways, railroads, industrial sites and farmlands. The U.S. Army Corps of Engineers constructed and manages the dam. Falls Dam (35°56′30″N78°34′57″W / 35.94167°N 78.58250°W / 35.94167; -78.58250) is an earthen structure having a top elevation of 291.5 feet (88.8 m) and an overall length of 1,915 feet (584 m). The height above the streambed is 92.5 feet (28 m).