Originally called "Hot Springs", it took the name of a popular radio program in 1950, when Truth or Consequences host Ralph Edwards announced that he would do the program from the first town that renamed itself after the show. Ralph Edwards came to the town during the first weekend of May for the next fifty years. This event was called the "Fiesta" and included a beauty contest, a parade, and a stage show.
According to the United States Census Bureau, the city has a total area of 12.8 square miles (33.1 km²), of which, 12.6 square miles (32.8 km²) of it is land and 0.1 square miles (0.3 km²) of it (0.86%) is water.
The city is located on the Rio Grande, near Elephant Butte Reservoir.
Before World War II, there were about 40 hot springs spas in Truth or Consequences. By 2002, the Hot Springs Association in Truth or Consequences had 8 spa facilities as members. Five of those obtained their water from wells, and Marshall Hot Springs, Indian Springs Bath House and Hay-Yo-Kay Hot Springs are from free flowing hot springs. The New Mexico State Energy and Minerals Department created two demonstration projects using geothermal energy in Truth or Consequences in the 1980s. The Carrie Tingley Hospital for crippled children, which has since moved to Albuquerque, used the state money to create a physical therapy program. The local Senior Citizen's Center benefits from a geothermal space heating system.
There were 3,450 households out of which 20.2% had children under the age of 18 living with them, 40.5% were married couples living together, 10.3% had a female householder with no husband present, and 46.1% were non-families. 41.2% of all households were made up of individuals and 22.1% had someone living alone who was 65 years of age or older. The average household size was 2.04 and the average family size was 2.75.
In the city the population was spread out with 20.2% under the age of 18, 5.7% from 18 to 24, 20.1% from 25 to 44, 24.6% from 45 to 64, and 29.3% who were 65 years of age or older. The median age was 48 years. For every 100 females there were 96.8 males. For every 100 females age 18 and over, there were 92.4 males.
The median income for a household in the city was $20,986, and the median income for a family was $28,750. Males had a median income of $23,214 versus $18,207 for females. The per capita income for the city was $14,415. About 15.6% of families and 23.2% of the population were below the poverty line, including 33.3% of those under age 18 and 18.1% of those age 65 or over.
It is served by Truth or Consequences Municipal Airport.
Truth or Consequences, a photographic portrait of the town, was published in 2001 by British photographer Nick Waplington.
Serial killer David Parker Ray lived in Truth or Consequences. On September 20 2001, he was sentenced to 224 years in prison for abduction, rape, torture and — in some cases — murder of at least 12 people, although the FBI estimates the total number of victims could be as high as 60.