The North America, Central America and Caribbean Athletic Association of the International Amateur Athletic Federation (NACAC/IAAF) was founded on December 10, 1988 at an extraordinary meeting held in San Juan, Puerto Rico convoked by the area representative and attended by the IAAF General Secretary, John B. Holt. Delegates from 20 of the 32 member federations debated at length a draft text that had been previously circulated and finally unanimously approved the current statutes which were ratified at the IAAF Congress in Barcelona in 1989.

The IAAF Constitution specifically provides that continental, area or group associations, confederations or committees may be formed for each of the six groups recognized by the IAAF (Rule 4.6) which shall draw up its own rules relating to its constitution and powers which shall in all cases be limited to operations within its own area and in no sense conflicting with any IAAF Rule.î The North America, Central America and Caribbean Athletic Association was the last of the six area associations to be established under that provisions.

The area representative, Amadeo Francis, was elected president of the association and, after several votes failed to unlock a tie, Dr. Bernard J. Nottage (BAH) and Neville McCook (JAM) were elected co-vice presidents. Keith Joseph (STV) was elected Treasurer.

The second congress of the Association was held on July 26, 1991 in Xalapa, Veracruz, Mexico on the occasion of the XIIIth Central American and Caribbean Senior Championships. During the Congress it was agreed to institute an educational program alerting athletes in the area as to the adverse effects of the use of illegal substances. A proposal by Mr. Anthony Minguel (AH0) to create a NACAC Cup in Athletics was tabled.

The third congress of the Association was held in San Juan, Puerto Rico on July 3, 1993. Anthony P. Minguel (AHO) was elected vice president. The statutes were amended to provide that the president of the IAAF would automatically be a member of the executive committee.

An extraordinary Congress of the Association was held in Mar del Plata, Argentina on March 23, 1995 during the Pan-American Games at which the membership amended the statutes to remove term limits on the members of the executive.

An extraordinary congress was held in Atlanta on July 30, 1994 on the occasion of the Centennial Olympic Games for the election of the officers of the Association which had been deferred at Mar del Plata when a faction of the membership questioned the legitimacy of the meeting alleging untimeliness in the issuing of the invitations for the congress (one year's advance notice is statutorily required). Alpheus Finlayson (BAH) was elected vice-president, the other officers remaining unchanged. There was a proposal to establish an athletesí commission, the integration of which would be developed by council member Alberto Juantorena (CUB).

The membership met in Nassau, Bahamas in September 1997 at which time a strategic planning session was held over three days at the conclusion of which a Vision Statement for the year 2010 was approved during the Congress that had been convoked for this purpose. As a part of this Vision, the concept of the first ever area championships was approved and a committee headed by vice president Alpheus Finlayson was mandated to draft rules and regulations for this major encounter. During the Congress, the membership also formally recognized the North America, Central America and Caribbean Track and Field Coaches Association.

An extraordinary meeting of the members attending the XVIII Central American and Caribbean Games in Maracaibo, Venezuela was held on August 18, 1998 at which the rules and regulations for the first area under-25 championships were approved. It was agreed to solicit bids for the venue where the initial event would be staged. 

The eighth Congress of the Association was held in Winnipeg, Canada on July 26, 1999 during the Pan American Games.  Fifty-one delegates from 28 members of the Association were approved.  It was agreed, as an amendment to the Constitutional Rules of the Association, that women should occupy 20% of the seats on the Council.  Officers for the following four year period were elected, with Amadeo I. D. Francis being re-elected President, Anthony Minguel, Vice President and Alfred Emmanuel (STV), Treasurer.  An attempt to elect the area representative failed, due to repeated ties, and the final vote was delayed until an extraordinary meeting which was held in Seville, Spain on August 17th, the eve of the IAAF Congress, at which Mr. Neville McCook (JAM) was elected to succeed Mr. Francis as area representative.  Evelyn Rockett (CAY) and Veda Bruno (GRN) became the first female members of the Council elected in accordance with the newly approved amendment.

The 9th Congress of the association was held in Edmonton, Canada on the 31st July, 2001 on the eve of the openning of the 43rd Congress of the IAAF. Delegates from 19 countries were present (several were delayed due to the cancellation of flights in the Caribbean). President Lamine Diack and General Secretary Istvan Gyulai addressed the assembly. Reports were heard from the President, Treasurer and Area Representative.

At the Congress held on the island of Grenada on July 3, 2003 Amadeo Francis was re-elected as President of the area association and Neville McCook as the area representative.  After a full discussioon the Congress decided to reduce the age limit for its bi-annual championships to athletes under 23 years of age in the year of competition (i.e., ages 20, 21 and 22)  The 2004  championships was awarded to the city of Sherbrooke, Canada.