The tournament was first played in 1980, when it was won by Toledo. Ball State has won the most tournaments with seven and Akron is the current tournament champion. No team has ever won the tournament three consecutive years; Ball State and Kent State have each won the tournament in two consecutive seasons.
The MAC announced a new format beginning with the 2012 MAC Men's Basketball Tournament. With the new format, seeding is determined by winning percentage, regardless of conference division. The No. 1 and No. 2 seeds receive byes straight to the semifinals, with the No. 3 and No. 4 seeds beginning tournament play in the quarterfinals. Teams seeded 5–12 play an additional two rounds. First round games are played at the home sites of the higher seeds, with the remaining rounds being contested at Quicken Loans Arena. With the new format, a team seeded fifth or lower has to win four games in six days, while playing five games in eight days, to win the conference tournament. The division winners are guaranteed to receive a seed not lower than four. Previously the division winners were guaranteed a least a No. 2 seed.
From 2002 through 2011, each of the 12 men's basketball teams in the MAC received a berth in the conference tournament. The top four seeds received byes into the quarterfinals. The winners of each division were awarded the #1 and #2 seeds. The team with the best record of the two received the No. 1 seed. First round games were played at the home sites of the higher seeds, with the remaining rounds being contested at Quicken Loans Arena.
From 1980 through 1988, seven teams qualified for the three-round tournament. The No. 1 seed received a bye into the semifinals. In 1989, an eighth team was added and each of the teams participated in all three rounds. In 2000, the tournament was expanded to four rounds and included all 13 teams in the league. The top three teams received byes into the quarterfinals. In 2002, the tournament field was reduced to 12 teams and the current format was adopted.