Together with brass markers set into the pavement, it records the position of the 15th-century Tolbooth of Edinburgh, demolished in 1817, which was the administrative centre of the town, prison and one of several sites of public execution. The tolbooth features in Sir Walter Scott's novel, The Heart of Midlothian, published in 1818.
Politically, the Heart is no longer in Midlothian because Edinburgh council has been separate from Midlothian for over a decade. The city currently incorporates former sections of West and East Lothian within it, but it was formerly the administrative centre of Midlothian, also known as "Edinburghshire" or the "County of Edinburgh" in the past. The football team Heart of Midlothian Football Clubs badge is based on the Heart.
Visitors to Edinburgh will often notice people spitting on the Heart. A tolbooth stood on the site, where executions used to take place; some people spit on the Heart for good luck. A popular legend says that by spitting on the heart, one is destined to one day return to Edinburgh.