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Middletown is located at (39.547, −84.527). It lies on the north bank of the Little Miami River, near its confluence with the Ohio River and about 12 miles from Cincinnati. According to the United States Census Bureau, in 2000 Middletown had a total area of , all land; this includes water surface areas such as Lake Lemon and portions of two rivers: The Little Miami River and Ohio river which are part of Middletown's border with Monroe County Kentucky across from Devou Park in Covington KY . As well as being adjacent to Dayton OH , it is also adjacent to Springfield OH .