The hosts of The Kids Choice Awards Past

Alan Goodman, Albie Hecht and Fred Seibert started the awards show as The Big Ballot in 1986, named for the ballots kids voted with. To vote, the viewers would send in ballots and then before the show, the ballots would be counted and the winners would tape a thank you video that would be shown during the program.

The award was configured into the current blimp shape/kaleidoscope in 1990. The only change to the award since that time has been to change the embossed logotype on the side of the trophy for 2010 to fit the network's new logo typeface.

As the Internet came into widespread use, the voting eventually moved from a combination of 900 number telephone voting and ballots either mailed or completed at Pizza Hut locations, to moving exclusively online to the network's website and by 2007, text messaging. Early years of Internet voting had the early adoption complications of ballot stuffing and even adults voting before a new system where only one vote per Nick.com account became the procedure for voting on the awards (although it is probable adults still cast votes via the texting option, which is connected to a phone number only rather than a screenname, or by creating an account with a false age or having their children vote for a chosen subject instead). In 2010, an iPhone application and mobile browser voting was also added.

The 2009 KCAs featured a new award called "The Big Green Help Award" which goes to the celebrity who goes above and beyond to help the Earth. The inaugural award was presented to Leonardo DiCaprio. For the 2010 awards, the "The Big Green Help" award was renamed "The Big Help" award, with First Lady Michelle Obama winning the first award under the rename.

Unlike traditional awards shows, the Kids' Choice Awards uses other items to announce an award winner rather than a traditional envelope. The show sometimes uses balloons, T-shirts, models, giant letters, stickers (1999, where Amanda put a "Kick Me!" sticky on the model's back and somebody else put a sticker showing the winner's name). and even a foot (2008). In contrast to the trend of declining ratings for awards shows, the Kids' Choice Awards has gone from strength to strength, setting new ratings records each of the past four years (2005–2009).

Voting for Canadians became available for the 2010 ceremony with the inauguration of Nickelodeon's Canadian service in November 2009.

In June 2011, Nickelodeon Latin America announced a Kids' Choice Awards for Mexico. Other countries with their own Kids' Choice Awards: Brazil, United Kingdom, Australia, and Indonesia.

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