The first meeting of the Million Dollar Round Table took place during the 1927 National Associate of Life Underwriters meeting at the Peabody Hotel in Memphis, Tennessee, USA. Paul Clark presided over 32 members in attendance. The meeting was made up of men who sold at least a $1 million worth of life insurance.


In 1928, MDRT's gained its first woman member when Eleanor Young Skillen joined.


By 1930, MDRT gained its first Canadian members, R.E. Campbell of Toronto and Brenton S. Brown of Vancouver. The first overseas member, Frank Noble Lowndes, of Sydney, Australia and London, England, also joined the same year, as did the second woman member, Sara Frances Jones. The first members from Japan, Iemon Fujih, Shigeo Kinoshita, Ikutaro Nakasone and Yasuyuki Oba, joined the organization in 1931.


In 1936, the first MDRT study group was formed by John O. Todd, CLU (1951 President), H. Kennedy Nickell, CLU (1941 President), Robert P. Burroughs (1942 President), Ron Stever, CLU (1943 President), Alfred J. Ostheimer (1944 President), Stanley E. Martin and Nathaniel H. Seefurth.


By 1946, MDRT held its first Annual Meeting in a location separate from the NALU Annual Meeting.


In 1949 MDRT's first paid employee, Harriet Preinetz, was hired. In the same year, MDRT's first permanent office was established at 1 N. LaSalle Street in Chicago, Illinois, USA.


1956 MDRT President Arthur F. Priebe, CLU, directed a corporate charitable gift in his honor to support the larger needs of the community, which led to the creation of the MDRT Foundation in 1959.


1957 marked two important milestones in MDRT’s development into a major association: It received tax-exempt status as a 501(c)(3), and the first executive director was hired.


At the 1962 MDRT Annual Meeting the late Mortimer J. Adler encouraged members to nurture the different areas of their lives. He explained that the professional part of our life allows us to live, but the other dimensions allow us to live well. This became the basis for MDRT's Whole Person concept, which encourages balance in family, health, education, career, service, financial and spiritual aspects of their lives and development of full human potential.


In 1974, the Executive Committee decided a new level of membership for MDRT’s top performers was needed. Top of the Table was officially named in 1977, and the first meeting was held in Phoenix, Arizona, USA.

In 1974, MDRT headquarters relocated to Des Plaines, Illinois, USA.


By the middle of the 1980s a need for an intermediate level of MDRT membership was identified. In 1985 MDRT welcomed its first Court of the Table members.


In 1990, MDRT relocated to its own building at 325 West Touhy Avenue in Park Ridge, Illinois, USA.