All of the current schools compete at the 3A level, the second-largest in Iowa.
In 1969 the high schools Bettendorf, Muscatine, and Assumption left the league for conferences that made more geographical sense.
Ottumwa, Burlington and Keokuk High Schools then invited Quincy, IL (Catholic Boys) to join them in a four-team league that maintained the Little Six Conference name.
Oskaloosa returned after the 1995-1996 School year after being asked to leave the South Central Conference due to enrollment numbers and after being denied membership into the Little Hawkeye Conference due to travel distance.
Starting with the 2019–2020 school year, Burlington joined the Southeast Conference, joining from the Mississippi Athletic Conference, of which it had been a charter member when formed (as the Mississippi Eight) in 1978.