The position was created in 1976 after the newly enacted Constitution of Portugal, which followed the 1974 Revolution, granted legislative autonomy to the Azores and Madeira archipelagoes, thus establishing the Portuguese Autonomous Regions and the respective governing bodies.

It is analogous to the position of president of the Legislative Assembly of the Azores and both are equally 14th in the Portuguese order of precedence, being this the highest ranking position of any regional governing body.

[1] Following the first Madeiran regional elections the same year, which resulted in the Democratic Peoples' Party (now Social Democratic Party) having the majority of members of parliament, Emanuel Nascimento dos Santos Rodrigues was elected the first president of the Legislative Assembly.

The current President is José Manuel Rodrigues, who is a member of the Assembly since 1996.

Two of the presidents were physicians (Nélio and Miguel Mendonça) and the other two were/are lawyers (Rodrigues and Tranquada Gomes) before taking office.