It was established by presidential decree nº 3 in 1992 and it is named after the Blue Nile River.

Its economic activity is based on agriculture and livestock and increasing mineral exploitation.

In 2011, residents of Blue Nile were scheduled to hold ill-defined "popular consultations" to determine the constitutional future of the state, per the Comprehensive Peace Agreement.

Instead, a dispute over the rightful government of the state, and the determination of Omar al-Bashir to eradicate the Sudan People's Liberation Movement–North, led to a renewed nine-year conflict between government forces and the Sudan Revolutionary Front as well as contributing to a refugee crisis.

[3][4] The conflict finally came to an end in 2020 after a peace agreement was signed and the government to not discriminate based on ethnicity or religion.