The American College of Cardiology was chartered and incorporated as a teaching institution in 1949, and established its headquarters, called Heart House, in Bethesda, Maryland, in 1977.

In July 2023, the college announced that Cathleen Biga, MSN, RN, FACC, would assume the role as president for 2024–2025.

Those achieving highest distinction in the field are awarded the title Master of the American College of Cardiology, which is bestowed upon a maximum of three practicing cardiologists each year.

Clinical data standards developed include those for acute coronary syndrome, atrial fibrillation, heart failure and electrophysiology.

The college's National Cardiovascular Data Registry is a source for measuring and quantifying outcomes and identifying gaps in the delivery of quality care.

In 2011, the college and The Society of Thoracic Surgeons launched the STS/ACC TVT Registry, which tracks transcatheter valve therapy procedures.

Currently several key quality initiatives are underway to help translate science into practice and improve outcomes for cardiovascular patients.

Imaging in FOCUS is a community designed to guide implementation of appropriate use criteria and ensure patients are receiving the right care at the right time; the initiative has produced innovations such as pocket cards and mobile applications; access to an online community; and access to webinars, educational programs and performance improvement tools.

The college also advocates for health policies that allow cardiovascular professionals to provide quality, appropriate and cost-effective care on such issues as Medicare physician payment, medical imaging, health care reform implementation, medical liability reform and funding for prevention and research.