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The district got its name from Medak, the headquarters of the Taluk of the same name at the time. Medak was originally known as Methukudurgam, which later became Methuku due to the growth of fine and coarse rice in the area. The Medak District became part of the Kakatiya Kingdom from the Bahmani Kingdom and later the Golconda Kingdom. Eventually, with the fall of the Qutubshahi Dynasty, it was annexed to the Mughal Empire. During the founding of the state of Hyderabad by Asif Jahi, this district was separated and incorporated into the Nizam's fiefdom. It eventually became a part of Andhra Pradesh which came into force from 1 November 1956 under the State Reorganization Scheme.

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