[3] Owned and operated by the Hawaii Department of Transportation, the airport serves windward (eastern) Hawaiʻi island including the districts of Hilo, Hāmākua and Kaʻū, and Puna.

[2][4] It is included in the Federal Aviation Administration (FAA) National Plan of Integrated Airport Systems for 2021–2025, in which it is categorized as a small-hub primary commercial service facility.

[5] In 1927 the Territory of Hawaii legislature passed Act 257, authorizing the expenditure of $25,000 for the construction of a landing strip in Hilo.

[6] During martial law in the territory following the attack on Pearl Harbor, all airports in the Hawaiian Islands came under the control of the U.S. military.

In addition to military facilities to support an Air Corp fighter squadron at Hilo, the Army expanded and improved runways, taxiways and aprons.

Although ownership of the airport was returned to the territory in September 1946, the Air Force leased the facilities and retained operational control of its tower for over three years after Japan's surrender.

[11] During the late 1950s, Territorial leaders anticipated a boom in tourism, prompting plans for a second runway capable of accommodating large jet aircraft.

In April 1958, the territory acquired 91.6 acres (37.1 ha) on the eastern edge of the airport for a longer runway to enable non-stop flights to the west coast of the United States.

[15] The airlines, however, did not wait until the new terminal was built; on February 6, 1971, the first jumbo jet landed: a 747 operated by Braniff International Airways.

In order to better serve the airport and its lengthened runway, the FAA opened a new, taller air traffic control tower on November 2, 1979.

In 1968, Northwest was operating Boeing 707-320C jet service nonstop to Hilo from Seattle (SEA) twice a week with this flight also providing direct, no change of plane service from New York JFK Airport (JFK), Philadelphia (PHL), Cleveland (CLE) and Chicago O'Hare Airport (ORD).

[16] In 1969, United was operating daily nonstop flights from Los Angeles (LAX) and San Francisco (SFO) with Douglas DC-8 jets including stretched Super DC-8-61 jetliners with direct, no change of plane Super DC-8 service being flown daily to Hilo from Chicago O'Hare Airport (ORD) and Boston (BOS) via LAX while Pan American (Pan Am) was flying daily nonstop Boeing 707 service from Los Angeles (LAX) with 707 flights also being operated three days a week nonstop from San Francisco (SFO) and two days a week nonstop from Seattle (SEA) with this latter flight originating at Portland (PDX).

[17][18] Also in 1969, Braniff was operating Boeing 707-320 jet service with weekly nonstop flights from Dallas Love Field (DAL), Houston Hobby Airport (HOU) and St. Louis (STL) with the airline also operating direct one-stop 707 service once a week to Hilo from Atlanta (ATL), Miami (MIA) and New Orleans (MSY).

[19] By 1971, Continental was flying Boeing 707-320C jetliners nonstop from Los Angeles (LAX) with direct, no change of plane 707 service being operated from Denver (DEN), Kansas City (MCI), Portland (PDX) and Seattle (SEA) with flights from PDX and SEA making an intermediate stop in Honolulu.

[21] A year later in 1976, Continental was once again serving Hilo with a daily direct McDonnell Douglas DC-10 flight from Denver (DEN) and Los Angeles (LAX) with this service making an intermediate stop in Honolulu while at this same time United was operating a Douglas DC-8 flight four days a week with a westbound routing of New York Newark Airport (EWR) – Cleveland (CLE) – San Francisco (SFO) – Hilo (ITO) in addition to operating daily nonstop Boeing 747 service from Los Angeles (LAX).

[22] Beginning in 1979, however, overseas passenger traffic began to fall steadily, leading one carrier after another to suspend service to Hilo.

[23] In early 1985, United was operating just one departure a day from Hilo: a daily nonstop to Los Angeles (LAX) flown with a stretched Super DC-8.

Meantime, in the summer of 1983 there were three airlines operating nonstop service on the interisland route between Hilo and Honolulu including Aloha Airlines with Boeing 737-200 jets, Hawaiian Airlines with McDonnell Douglas DC-9-50 jets and de Havilland Canada DHC-7 Dash 7 turboprops, and Mid Pacific Air with NAMC YS-11 turboprops with the three air carriers operating a combined total of seventeen daily nonstop flights at this time from Hilo to Honolulu according to the OAG.

[28] Efforts finally had some success on April 28, 2006, when ATA Airlines re-established daily non-stop service between Hilo and Oakland International Airport in California aboard its Boeing 737-800 aircraft.

Just shy of two years later on April 2, 2008, ATA Airlines ceased operations, citing the cancellation of an agreement by FedEx that provided most of the company's charter flights, and the unprecedented increase in fuel prices.

It is capable of accommodating overseas passenger service by aircraft as large as the Boeing 747 and is used occasionally by the Lockheed C-5 Galaxy, a USAF military transport.

The passenger terminal complex, including commuter facilities, is at the southern edge of Hilo International Airport and is served by an access roadway from Hawaii Belt Road at Kekūanaōʻa Avenue.

The Northwest Apron, which serves this area of the airport, provides parking for transient military aircraft and is the site of some general aviation facilities.

[37] In fact, whereas the number of visitor accommodations elsewhere in the state climbed steadily since the 1970s, in east Hawaiʻi island several hotels have been shuttered or converted into apartments or condominiums.

Exacerbating the impact of airport activity on nearby residential neighborhoods is the fact that Hilo's climate favors single wall, open air construction to take advantage of natural ventilation provided by trade winds.

[38] Complaints about airport noise have been received from locations including downtown Hilo, hotels and condominiums along Banyan Drive, and Keaukaha.

In response, the Hawaiʻi State Department of Transportation implemented measures designed to mitigate airport noise.

Night and early morning flights are directed to arrive from and depart towards the east, where largely vacant land acts as a noise buffer.