His Royal Highness, the Prince of Wales, donated the trophy to the NHL in 1924. From 1927-28 through 1937-38, it was presented to the team finishing first in the American Division. (The team finishing first in the Canadian Division received the O'Brien Trophy during these years.)
From 1938-39, when the NHL reverted to one division, to 1966-67, the Prince of Wales Trophy was presented to the team that won the regular-season championship. After expansion in 1967-68, it again became a divisional trophy and was awarded to the regular-season champion of the East Division through the end of the 1973-74 season. Beginning in 1974-75, it was awarded to the regular-season winner of the conference bearing the name of the trophy.
From 1981-82 through 1992-93, the trophy was presented to the playoff champion in the Wales Conference. Since 1993-94, it has been presented to the playoff champion in the Eastern Conference.
Because of temporary divisional realignment due to COVID-19 in 2020-21, the third round of the playoffs was renamed the semifinals, instead of the conference finals. The Prince of Wales Trophy was awarded to the Tampa Bay Lightning after they defeated the New York Islanders in the semifinals.