It was first introduced during the 1970–71 season, with the inaugural winners being Bristol Harlequins.

A plate competition was introduced during the 1985–86 season for teams knocked out of the early rounds of the Bristol Combination Cup, with St Brendans Old Boys being the inaugural winners.

The plate was discontinued at the end of the 2002–03 season and has since been replaced by the Bristol Combination Vase, which is for lower ranked clubs in the region.

The Bristol Combination Cup is currently open for clubs sides based in Bristol and the surrounding countryside (including parts of Gloucestershire and Somerset), playing in tier 4 (National League 2 South), tier 5 (National League 3 South West) and tier 6 (Tribute South West 1 West) of the English rugby union league system.

The format is a knockout cup with quarter-finals, semi-finals and a final to be held at the Memorial Stadium in Bristol in April–May.