At Final Battle, December 15, 2017, it was announced that a tournament to crown the first Women of Honor Championship holder would start on January 20, 2018.

[3] On April 7, 2018, Sumie Sakai became the inaugural champion by defeating Kelly Klein in the 16-women tournament finals at Supercard of Honor XII in New Orleans, LA.

[5] Also during year 2019 of this title's existence, the Women of Honor World Championship was defended in Japan at a Stardom event by Mayu Iwatani after she defeated Kelly Klein for the title at ROH pay-per-view Bound By Honor[6][7] (during Klein's first reign and became champion for the first time in her career) in addition to ROH shows, pay-per-views, and events.

[12][13] During Kelly Klein's third reign, ROH producer Joey Mercury left the promotion.

In a series of tweets, Mercury said ROH doesn't have a concussion protocol and Klein had to wrestle while injured.