The jurisdiction was established in 1919 as Apostolic Administration of Eupen–Malmedy–Sankt Vith (a normally missionary pre-diocesan type of jurisdiction), on Belgian-occupied German territory split-off canonically from the Metropolitan Archdiocese of Cologne (Köln) and entrusted to Archbishop Sebastiano Nicotra (1919 – 1920.07.30), then apostolic nuncio, the representative of the Holy See, to the Belgium government and the Catholic Church in Belgium.
The German areas Eupen and Malmedy were transferred from defeated Central power Germany to the Allied Kingdom of Belgium in 1920, conforming to the Treaty of Versailles, as part of the hefty compensation (besides huge reparation payments) for the losses the country had suffered during conquest and occupation in World War I.
When the situation escalated, Cardinal Mercier, Primate of Belgium as Metropolitan Archbishop of Mechelen-Brussel, asked Pope Benedict XV to establish a diocese which would encompass the new Belgian territories.
On 30 July 1920, the diocese of Eupen-Malmedy was created by elevating the apostolic administration (losing St-Vith in its name) with the publication of the papal bull Ecclesiae Universae.
The Saints-Pierre, Paul et Quirin church of Malmedy became the cathedral episcopal see of the new bishop.