The title was created in January 1974 and, as its name suggests, is defended exclusively within Puerto Rico.
The location represented in the title's name has changed twice, both times in unofficial fashion after being rechristened and modified by its current holder in under to sell a villainous persona.
During Fidel Sierra's second reign, which began on June 2, 2001, and lasted for three months, he defended the title under the name of "Cuba Heavyweight Championship".
To illustrate this change, he covered the word "Puerto Rico" in the main banner with a sticker that was inscribed with the word "Cuba", also covering the map of Puerto Rico that was featured in the center of the plate with a sticker of the flag of Cuba.
Sierra also covered the side plates with photos of him and his manager, Fantasy.