Cape Fear Indians were likely associated with North Carolina's eastern Siouan tribes, possibly the Waccamaw, but it is not clear whether they were independent or part of some other tribe. The native name for the tribe is unknown, and no vocabulary has been preserved. Although five Cape Fear Indian villages were reported to have existed in 1715, the only village mentioned by name is Necoes, located approximately 20 miles from the mouth of the Cape Fear River, probably in modern-day Brunswick County. The tribe's population in 1600 was estimated at 1,000. Contact with the Cape Fear Indians was made by several early voyagers, including Giovanni da Verrazano in 1524 and William Hilton in 1661 and 1663. Hilton is reported to have met with Watcoosa, "king" of the Cape Fear Indians, at Crane Island (now Big Island, about 13 miles below Wilmington). Watcoosa is said to have sold Hilton the river and contiguous lands. In 1664, after settlers seized some Indian children and sent them away, evidently into slavery, the Indians drove the settlers away.
Threatened by increasing European settlement, the Cape Fear Indians in 1695 asked Governor John Archdale for protection, which was granted. A few Cape Fear Indian scouts accompanied John Barnwell during the Tuscarora War in 1711-12. Many Cape Fear Indians were driven out of the Cape Fear region by Col. Maurice Moore and a force of Tuscaroras during the Yamassee War in 1715. A Cape Fear Indian settlement at Big Sugar Loaf (now in Carolina Beach State Park, on the east bank of the Cape Fear River) was decimated by Roger Moore in 1725, after an alleged Indian raid on his Orton Plantation. Little presence of the tribe is reported on the Lower Cape Fear River after 1730. Remnants of the tribe were said to have joined with the Peedee in South Carolina. No mention is made of the Cape Fear Indians after 1808.