The title is part of a long lineage that was started when the NWA Southern Junior Heavyweight Championship, in use since 1939, was renamed the NWA Southern Heavyweight Championship (Memphis version) in 1974.

The title's name changed again in 1978, when it was renamed the AWA Southern Heavyweight Championship due to a partnership with the American Wrestling Association.

It was also called the Mid-Southern Heavyweight Championship in Pro Wrestling Illustrated and its sister publications, in order for this title to not be confused with Championship Wrestling from Florida's version of the title.

The title was revived in the United States Wrestling Association from 1989 until 1997 when the USWA closed.

It was known as the USWA Southern Heavyweight Championship and later simply the USWA Heavyweight Championship during that time; however, unlike the previous Southern title in Memphis, this one played a secondary role to the USWA Unified World Heavyweight Championship.