The orchestra first performed as the City of Birmingham Orchestra in September 1920, with Appleby Matthews conducting its first concert. The programme included Overture: Saul by Granville Bantock, a strong supporter of the orchestra's foundation. However, its official foundation is generally reckoned to have been the "First Symphony Concert" in November 1920, when Edward Elgar conducted a programme of his own music in Birmingham Town Hall. The orchestra's founder was Neville Chamberlain, who later became Prime Minister of the United Kingdom and declared war on Germany in 1939.
The CBSO began to gain greater international renown after Simon Rattle became chief conductor in 1980. Under him, the orchestra increased its recording profile and became one of the leading ensembles in Europe, and gained a name for its interpretations of late romantic and 20th century works, especially those of Sibelius and Gustav Mahler. During this period, the orchestra moved from Birmingham Town Hall to a new home venue, Symphony Hall, inside Birmingham's International Convention Centre. The nearby CBSO Centre, a converted factory, houses management offices, rehearsal facilities, and is a concert venue in its own right, for more intimate performances.
Rattle was named music director of the CBSO in 1990. That same year, the post of Radcliffe Composer in Association was created, with Mark-Anthony Turnage filling the role. In 1995 Judith Weir became Fairbairn Composer in Association, followed in 2001 by Julian Anderson.
After Rattle relinquished his posts with the CBSO, the Finnish conductor Sakari Oramo became chief conductor in 1998, and music director in 1999. His CBSO work has included the Floof! festival of contemporary music. He has also championed the music of John Foulds in concerts and recordings. In 2006, the orchestra announced that Oramo is scheduled to step down in 2008 and take the title of principal guest conductor.
In October 2007, the orchestra named the Latvian conductor Andris Nelsons as the CBSO's 12th music director, effective with the 2008–2009 season. Nelsons' initial contract is for 3 years. The appointment is unusual in that Nelsons had not conducted the CBSO publicly prior to his appointment, but only in a private concert and in a recording session.
In 2001, the players rejected a contract that would have stopped extra payments for broadcasts and recordings, in the context of financial crisis at the CBSO. In addition, other controversy arose from the CBSO's demands from the Arts Council for a greater share of the Council's stabilisation fund, because of its reputation compared to other British orchestras.
The CBSO has recorded substantially for EMI Classics and Warner Classics, as well as smaller labels. The Orchestra's chief executive, appointed in 1999, is Stephen Maddock.