A number of regional Lutheran churches in southern Africa began unity discussions in the late 1960s.

A 1969 meeting of the Unity Committee made the decision to proceed to merger, with the resulting unified church to be divided into four constituent dioceses.

In 1972, the Cape Orange Lutheran Church joined the process, and the number of proposed dioceses was subsequently increased to five.

This assembly was unexpectedly attacked, with teargas bombs thrown through the windows, resulting in seventeen delegates being hospitalised.

The executive function of ELCSA is vested in the Church Council, a smaller body that can meet more frequently.

The ELCSA has a predominantly black membership, but actively seeks the full racial integration of Lutheran Christians and denominations in the region.

[9] During the long period of his incarceration in the Robben Island prison, Nelson Mandela received pastoral care and spiritual counsel from the ELCSA, principally through the offices of Bishop Adalbert Brunke of the Cape Orange diocese, who was subsequently to receive public thanks from President Mandela for his sacrificial ministry.