Unlike the rest of the Miss and Teen state pageants in the Miss USA system have annually scheduled at the same time, these Miss and Teen pageants in Texas are held separately in different months, the Miss pageant goes first and is held on the first Sunday of September every year. Those events have affected the regular September schedule as the 2018 pageant was held in January 2018 due to Hurricane Harvey devastated the pageant's host city, Houston; and the 2021 pageant was held in September 2021 due to the COVID19 pandemic, exactly a year originally planned for September 2020.

Ten Miss Texas USA titleholders have won the Miss USA title, including Chelsi Smith, who has been crowned Miss Universe. In the 1980s Texas won the Miss USA title five consecutive years from 1985 to 1989, a streak known as the "Texas Aces". Prior to this, no state had ever won the Miss USA pageant more than two times in succession. Past state directors have included Richard Guy and Rex Holt, "GuyRex" and Al and Gail Clark of "The Crystal Group".

The current titleholder is Allison Drake of Dallas, Texas, who assumed the position after R'Bonney Gabriel's win at Miss USA 2022 and eventually Miss Universe 2022. She was originally the second runnerup and only assumed the title when Sydni Leonard, the first runnerup to Gabriel at the state pageant, declined the offer. Miss Texas USA 2023 will be crowned on July 15, 2023, and the pageant will be held in Houston.

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