Instituted on 2 January 1954, the award is given for "distinguished service of a high order ... without distinction of race, occupation, position or sex".

The Padma Bhushan, along with other personal civil honours, was briefly suspended twice, from July 1977 to January 1980 and from August 1992 to December 1995.

The recommendations received between 1 May and 15 September of every year are submitted to the Padma Awards Committee, convened by the Prime Minister of India.

[3] The original specification of the award was a circle made of standard silver 1+3⁄8 inches (35 mm) in diameter, with rims on both sides.

The State Emblem of India was placed in the centre of the reverse side with the text "Desh Seva" in Devanagari Script on the lower edge.

The medal was suspended by a pink riband 1+1⁄4 inches (32 mm) in width divided into three equal segments by two white vertical lines.

The medal is suspended by a pink riband 1+1⁄4 inches (32 mm) in width with a broad white stripe in the middle.

"[14][15] Sitar player Vilayat Khan declined to accept the award in 1968, stating that "the selection committees were incompetent to judge [his] music."

[21] Novelist Khushwant Singh, who accepted the award in 1974 in the field of literature and education, returned it in 1984 as a notion of protest against the Operation Blue Star.

[16] Pushpa Mittra Bhargava, 1986 recipient and scientist and founder-director of Centre for Cellular and Molecular Biology (CCMB), returned his award in 2015 in protest of the Dadri mob lynching and out of concern at the "prevailing socio-politico situation" in the country.

[22] The 2010 conferment on an Indian-American businessman Sant Singh Chatwal, who was awarded the Padma Bhushan in the field of Public Affairs, created much controversy.

"[25] The Government provided clarification regarding the conferment and issued a press release which mentioned Chatwal as a "tireless advocate" of the country's interest in the United States.

The statement also mentioned that "due diligence" exercise is carried out for each of the awardees and out of five Central Bureau of Investigation (CBI) registered cases against Chatwal between 1992 and 1994, three were closed by CBI itself and in remaining two cases, Chatwal was discharged by the Court and as per the reports that were made available to the selection committee, there is nothing adverse on record against him.

The then Indian Ambassador to the United States Ronen Sen had told PMO that the conferral would not be appropriate because of the controversy associated with his financial dealings in India and America.

The bestowal would not only "demoralise the others who had done much more" but also would create "the impression that India did not regard lack of transparency in financial dealings as a disqualification for its highest honours.

"[30] In 2022, former West Bengal Chief Minister Buddhadeb Bhattacharya refused to accept his award on the eve of the 73rd Republic Day of India.