The awards were first presented in 1982 on the centennial of President Roosevelt's birth as well as the bicentennial of diplomatic relations between the United States and the Netherlands.

In odd years the awards are presented to American citizens or institutions by the Franklin and Eleanor Roosevelt Institute in New York City, though in the past the American awards were given in Hyde Park, New York.

In even years the award ceremony is held in Middelburg and honors non-Americans.

The choice of Middelburg was motivated by the suspected descendance of the family Roosevelt from Oud-Vossemeer in the municipality Tholen.

The first is freedom of speech and expression — everywhere in the world.The second is freedom of every person to worship God in his own way — everywhere in the world.The third is freedom from want — which, translated into world terms, means economic understandings which will secure to every nation a healthy peacetime life for its inhabitants — everywhere in the world.The fourth is freedom from fear — which, translated into world terms, means a world-wide reduction of armaments to such a point and in such a thorough fashion that no nation will be in a position to commit an act of physical aggression against any neighbor — anywhere in the world.