The County Hurdle was established in 1920, and its inaugural winner was Trespasser, ridden by George Duller. Its title between 1995 and 2016 was the '''Vincent O'Brien County Handicap Hurdle''' in honour of
Vincent O'Brien, an Irish
racehorse trainer who retired in 1994. During his career O'Brien recorded a total of twenty-three victories at the Cheltenham festival. For many years the County Hurdle was traditionally the last race to be run at the Festival. However, a new running order was announced ahead of the 2009 meeting, and it is now the second race on the final day. The race held Grade 3 status until 2022 and was reclassified as a Premier Handicap from the 2023 running when Grade 3 was renamed by the
British Horseracing Authority. In 2024, the race changed sponsor from McCoy Contractors to BetMGM ==Records==