The developer, MTR Gaming Group, broke ground in October 2005 for the new facility, which opened on February 28, 2007.

[1] In January 2019, Eldorado Resorts (the successor of MTR Gaming) sold the property to Churchill Downs Inc. for $178.9 million.

The racing surface is the synthetic material Tapeta Footings (a mixture of sand, rubber, fiber with a wax coating[3]).

[3] Gaming revenue is split between the operator (45%) and the Commonwealth of Pennsylvania (55%), the latter of which will use the funds for property tax relief, economic development and tourism, and the horse racing industry.

On February 6, 2019, the Pennsylvania Gaming Control Board approved a sports betting license for Presque Isle Downs & Casino.