The title was introduced in 2003 as the Psychotic Wrestling Alliance (PWA) Western States Heritage Championship. After the PWA forked following a management disagreement, the promotion was renamed Lords of Pain Wrestling (LPW) to reflect the Lords of Pain.net home that had hosted the e-federation, with the title also renamed to reflect the acronym.
The championship has had several name changes during different reigns: the PWA Southern States Heritage Championship during Austin's reign, the PWA Transylvanian Heritage Championship during Bloodrose's reign, and the LPW Cleansed Championship during cYnical and White Falcon's respective reigns.
The first champion was Lex Luthar, who won the championship against Villiano 187. Overall, there have been 15 different champions.