The winner of 1950's "Miss America 1951" pageant, Yolande Betbeze, refused to pose in a swimsuit from major sponsor Catalina swimwear. As a result, the brand's manufacturer Pacific Mills withdrew from Miss America and set up the Miss USA and Miss Universe contests. The first Miss Universe Pageant was held in Long Beach, California in 1952. It was won by Armi Kuusela from Finland, who gave up her title to get married to a Filipino tycoon shortly before her year was complete. Until 1958 the Miss Universe title (like Miss America) was post-dated, so at the time Ms. Kuusela's title was Miss Universe 1953.

The pageant was first televised in 1955. CBS began nationally broadcasting the Miss USA and Miss Universe pageants combined from 1960, and separately from 1965. In 2003, NBC took over the television rights.

The main pageant was held in the United States until 1972, when it was hosted by Dorado, Puerto Rico. Since then it has usually been held in a different city each year, though Manila, Miami, Los Angeles, Las Vegas, Bangkok and Panama City have each hosted it twice.

The Miss Universe Organization, a New-York-based partnership between NBC and Donald Trump, has run the contest since June 20, 2002. The current president is Paula Shugart. The Organization sells television rights to the pageant in other countries, and also produces the Miss USA and Miss Teen USA contests. The winner of Miss USA represents the USA in Miss Universe..

The main Miss Universe Pageant, as of now is held over a two week period between May-July. In the 70s through the 1990s, the pageant was a month-long extravaganza. This allows time for rehearsals, appearances and the preliminary competition, with the winner being crowned by the previous year's titleholder during the final competition. According to the organisers, the Miss Universe contest is more than a beauty pageant: women who aspire to become Miss Universe must be intelligent, well-mannered and cultured. Often a candidate has lost because she did not have a good answer during the interview rounds; although this section of competition has held less importance during recent pageants than it did in the twentieth century. Delegates also compete in swimsuit and evening gown competitions.

Currently, the final placement of the finalists is determined by a ranked vote, where each judge ranks each of the final three/five candidates, with the contestant posting the lowest cumulative score becoming the winner. If there is a tie, which often happens when there are even members of the jury, the higher semifinal scores become decisive.

The winner is assigned a one-year contract with the Miss Universe Organisation, travelling overseas to spread messages about the control of diseases, peace, and public awareness of AIDS. Since Donald Trump took over the pageant, the winner has been given the use of a Trump Tower apartment in New York City for use during her reign.

Aside from the main winner and her runners-up, special awards are also given to the winners of the best National Costume, Miss Photogenic and Miss Congeniality. Miss Congeniality is chosen by the delegates themselves, while in recent years Miss Photogenic has chosen by popular internet vote (the winner used to be chosen by media personnel covering the event).