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​Photos courtesy of © 2016 IMG Universe, LLC
The Miss USA pageant was conceived in 1950 when Yolande Betbeze, winner of the rival Miss America pageant, refused to pose for publicity pictures while wearing a swimsuit. Pageant sponsor Catalina decided to pull their sponsorship off the pageant and create their own competition.  Other owners have included a subsidiary of Gulf+Western Industries, ITT Corporation, and Donald Trump.

The first Miss USA and Miss Universe pageants were held concurrently in Long Beach, California in 1952; the first Miss USA winner was Miss New York USA Jackie Loughery. There were thirty delegates in the first year of competition, and many states did not compete every year during the first two decades of the pageant's history. From the 1970s, each state and the District of Columbia have sent a delegate each year. Alaska first competed in 1959 and Hawaii in 1960. Both had competed at Miss Universe until this time.

The pageant aired on CBS from 1963 until 2002, and for many years was known for having a CBS game show host as pageant host. John Charles Daly hosted the show from 1963–1966, Bob Barker from 1967 (he was not a regular for the CBS network until 1972 when he became host of The Price Is Right which he hosted until 2007) until 1987 (at which point he quit in a dispute over fur coats), Alan Thicke in 1988, Dick Clark from 1989 to 1993, and Bob Goen from 1994 to 1996. The show's highest ratings were in the early 1980s, when it regularly topped the Nielsen ratings. Viewership dropped sharply from the 1990s to the 2000s, from an estimated viewership of 20 million to an average of 7 million from 2000–2001.  In 2002, owner Donald Trump brokered a new deal with NBC, giving them half-ownership of the Miss USA, Miss Universe and Miss Teen USA and moving them to NBC on an initial five-year contract. The pageants were first shown on NBC in 2003.

Historically, the winner of the Miss USA title represented the U.S. in its sister pageant Miss Universe. Since its inception, eight Miss USA titleholders have gone on to win Miss Universe. In the mid-1960s, the organization established a rule that when a Miss USA wins the Miss Universe title, the first runner-up assumes the Miss USA title for the remainder of the year. This occurred in 1980, 1995, 1997, and 2012. In 1967, the first runner-up Susan Bradley of California declined the title and the crown went to the second runner-up Cheryl Patton of Florida. The only instance when a first runner-up assumed the title of Miss USA prior to this period was in 1957, when Mary Leona Gage of Maryland resigned after it was discovered she was married.