Outside North America and parts of English-speaking Canada, it is generally synonymous with the terms hors d'oeuvre, appetizer, or starter.
In the United States and parts of English-speaking Canada, the term entrée instead refers to the main course or the only course of a meal.
[a] The word entrée as a culinary term first appears in print around 1536 in the Petit traicté auquel verrez la maniere de faire cuisine, more widely known from a later edition titled Livre fort excellent de cuisine[b], in a collection of menus[c] at the end of the book.
Sausages, offal, and raw watery fruits (oranges, plums, peaches, apricots, and grapes) were apparently considered uniquely appropriate for starting the meal, as those foods appear only in the entree de table.
The distribution of dishes is very similar to that of the menus in the Ménagier de Paris, written 150 years before the Petit traicté.
[7] The distinct characteristics of the entrée were at first loosely observed, or perhaps more accurately, the "rules" were in a formative stage for several decades.
[10] Moist cooking methods were characteristic of the entrée stage of the meal, typical preparations being sautés, ragoûts, and fricassées.
Savory pies and pastries were baked in dry heat, but the enclosed meat cooked in its own steam and juices.
[17] In the late 17th century, "hors d'œuvre" were served in both the entrée and entremets stages of the meal as little "extra" dishes.
[21] Due at least in part to the collapse of the church’s authority in France, rules governing meat and lean days were followed irregularly.
[22] After the 1820s, the bouilli was no longer routinely served at fine dinners,[23] having been replaced by a wider variety of relevés.
In the United States and parts of English-speaking Canada, though, the older understanding of the entrée as a substantial meat course persisted, and the word came to refer to the principal dish of the meal.