In 1906 construction on the town's first municipal water system began at a cost of $25,000 with the first water pipes made of wood.Since 1913 board sidewalks began disappearing in favor of paved walkways. It was said that Rexburg's main street itself was so muddy at times that a horse supposedly drowned one spring in one of the downtown mud holes. So street paving began in 1917 and Rexburg was publicized as having the widest main street in the state.

In 1951 the Madison Memorial Hospital was opened. Before that time several residences were used in the city for hospital purposes. Today Madison Memorial Hospital is a modern expanded facility which offers many specialized services with state of the art technology and highly trained doctors and staff.

On June 5, 1976, Rexburg's main street once again was filled with mudholes and sufficient water to drown a horse when the Teton Dam broke sending a deluge of floodgates down on the surrounding lowlands including Rexburg. It first began as a leak coming from the right abutment at 7:45 a.m. This weakened the interior of the dam and allowed the pressure of the water in the reservoir to erode the dam further. When the dam collapsed at 11:57 a.m. the reservoir washed out the northern part of the dam unleashing about 80 billion gallons of water, flooding about 300 sq. miles of the valley. Livestock, houses and debris of all sorts could be seen carried along by the flood water. Houses were torn from their foundations and carried right through town. Huge logs from the lumber company acted as battering rams and caused much damage before coming to rest alongside of damaged homes and businesses. Later when the water began to subside and people waded back to their homes and businesses, they found the damage to be almost overwhelming.

With the help of many volunteers, Utah Power and Light Company employees, the LDS Church, the Red Cross and many others, the cleanup job began. The Teton Dam Flood Museum documents this disaster with pictures, videos and other memorabilia. It is currently housed in the historic Rexburg Tabernacle.

Rexburg made a marvelous recovery from the Teton Dam disaster and has continually upgraded its religious, educational, health, and recreational facilities as well as its cultural activities for the benefit of the residents. Today Rexburg is still known for its wide streets, spacious parks, and its educational and public facilities.

Since March 1883, the town has literally been transformed from a sagebrush desert into the beautiful thriving agricultural community of today. This city has grown and prospered into the hub of commerce for most communities in the Upper Snake River Valley. Rexburg is also well known as the host of the Idaho International Dance and Music Festival and the home of BYU-Idaho, a thriving institution of higher learning.