The district dates back to the Amt Meißen, which was first mentioned in 1334. The district was ruled by the Wettin dynasty. The Margraves of Meissen created the administrative division (Amt) in the 13th century. In 1835 the Amt was converted into an Amtshauptmannschaft, with the area of the current district covered by the Amtshauptmannschaften Meissen, Dresden and Großenhain. In 1939, these were renamed Landkreise (districts). In the administrative reform of 1952, several municipalities were transferred to the districts of Freiberg and Döbeln. In 1990, the old district borders were restored, and in 1996 parts of the district Dresden-Land were added. In August 2008 the district of Riesa-Großenhain was added to the district to give it its current size.
The coat of arms show a lion, the symbol of the counts of Meissen. The coat of arms were granted on November 16, 1992, and again after the enlargement of 1996 on February 20, 1997. It is identical to that of Flanders.