The championship was generally contested in professional wrestling matches, in which participants execute worked finishes rather than contend in direct competition.

Pat O'Connor was conditionally recognized as the first champion upon the AWA's secession from the NWA as O'Connor held the NWA World Heavyweight Championship, which he had won on January 9, 1959, though he was ordered to defend against Verne Gagne within 90 days or he would forfeit the AWA title to Gagne.

The promotion also created their own version of the AWA World Heavyweight Championship.

In April 2007, World Wrestling Entertainment (WWE) filed a lawsuit against Dale Gagner citing trademark infringement, as WWE owned all American Wrestling Association properties due to their purchase after the AWA's closure,[1][2][3] including the AWA World Heavyweight Championship.

The court ruling prohibits Gagner from exploiting or trading on the AWA name or any other derivatives.