Middlesex's housing stock reflects its post-World War II growth pattern. The borough holds a blend of older single-family homes on modest lots, mid-century ranch and split-level houses built during the suburban expansion of the 1950s and 1960s, and a number of apartment complexes that appeared as the population climbed. The historic Lincoln neighborhood grew up around a former railroad stop, and its street pattern retains an early-20th-century scale. Because the borough is compact, most homes sit within a short distance of Route 28, schools, and local parks, and the housing stock skews toward smaller, more affordable single-family properties relative to larger homes found elsewhere in Middlesex County.

The Lincoln neighborhood is among the borough's most historically rooted areas, taking its identity from a railroad station that once served the community. Its tree-lined streets and older homes contrast with the newer developments and apartment complexes built during the postwar decades. Middlesex is a compact borough, so neighborhoods flow into one another around Route 28, the schools, and the recreation fields, with most residents living within a short walk or drive of the borough's commercial corridors and civic buildings.

Middlesex has the rhythm of a close-knit suburban borough: school events, recreation-league games, and small local businesses anchor daily life. The borough has pursued redevelopment to refresh its commercial areas while retaining its residential character. Residents benefit from Middlesex County's extensive park network for outings, and the borough's recreation department organizes programs and maintains playgrounds, fields, and gathering spaces. Its position between the Raritan Valley and the Route 22 corridor places shopping, dining, and employment centers within easy reach.

Public education in Middlesex is provided by the Middlesex Borough School District, headquartered on John F. Kennedy Drive. The district serves students from the borough's neighborhoods through the local public schools, with campuses distributed across the compact borough. Families in the area also draw on the educational resources of surrounding Middlesex County, and the borough's history shows a long-running commitment to building and expanding schools as the population grew during the postwar era.

New Jersey Route 28 is the borough's main highway, providing access to Interstate 287, while U.S. Route 22 runs just to the north. Commuters heading into New York City can take NJ Transit's 114 bus route to the Port Authority Bus Terminal in Midtown Manhattan, and the 65 and 66 routes offer service to Newark. This combination of local roadways and direct bus service makes Middlesex a practical base for commuters working in either Manhattan or Essex County.

Middlesex Borough maintains recreation fields, playgrounds, and community gathering spaces, including a gazebo, pavilion, courts, and playing fields managed by its recreation department, which also organizes programs and special events throughout the year. Residents additionally have access to the Middlesex County parks system, which encompasses roughly 3,000 acres of developed and active parks offering sports fields, walking trails, and space for family outings across the county.