Since Tennessee became a state in 1796, four speakers of the Senate have succeeded to the governorship: Under the Tennessee Constitution, in the event of succession the Speaker does not become "acting governor" or "interim governor," but assumes the title and full powers of the governorship, much as the vice president of the United States becomes president upon the death, resignation or removal from office of the president.

However, this provision has not been put into practice since the gubernatorial term was extended to four years in 1953.

The title of lieutenant governor is granted to the speaker by statutory law enacted in 1951 in recognition of the fact that the speaker is the governor's designated successor; such has been the case since the adoption of the first state constitution and Tennessee statehood in 1796.

The following is a list of people who have served as Lieutenant Governor of Tennessee (formal title: Lieutenant Governor and Speaker of the Senate) since the current Tennessee State Constitution was adopted in 1870.

Lieutenant Governor Ron Ramsey (who served 2007–2017) was the first Republican to hold this office since the adoption of the current constitution, all previous ones having been Democrats.