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The borough was established in 1972 by an election of the majority Indigenous people in the region, following Congressional passage of the Alaska Native Claims Settlement Act. Most are Inupiat. The borough was named for the Alaska North Slope basin. In 1974 it adopted a Home Rule Charter, enabling it to exercise any legitimate governmental power. The borough has first-class status and exercises the powers of planning, zoning, taxation, and schools.
In 2020 airline Ravn Alaska went into bankruptcy and ended operations. The government of North Slope Borough attempted to take control of the airline's assets in an attempt to keep flights and shipments coming to the community, but the Alaska Attorney General stated that the borough did not have that authority.