In 1837, the Medical Practice Act was written by Dr. Anson Jones, one of the few formally trained physicians in Texas at that time. The Congress of the Republic of Texas then created the Board of Medical Censors for the purposes of administering examinations and granting medical licenses. The Board was discontinued by legislative act in 1848, but another regulatory law for physicians was enacted in 1873.

The Texas State Board of Medical Examiners was formed in 1907. It consisted of 11 physician members appointed biennially by the governor and confirmed by the senate.

In 1931, the legislature increased the number to 12 physicians appointed for six year terms. Sunset legislation passed in 1981 provided that nine physician members be doctors of medicine, three be doctors of osteopathy, and that three public members be added. 

In 1993, three additional public members were added, bringing the total to 18. In 2003, an additional public member was added, bringing the board to its current total of 19 members.

The 79th Legislature changed the name to Texas Medical Board, effective September 1, 2005.