The airport was named Bluethenthal Field on Memorial Day, May 30, 1928, in honor of Arthur Bluethenthal, a former All-American football player and decorated World War I pilot who was the first North Carolinian to die in the war.

During World War II, the airfield was used by the United States Army Air Forces Third Air Force for anti-submarine patrols and training using P-47 Thunderbolt aircraft. The Army expanded the airfield with three new 7,000-foot runways, and after the war, deeded the site back to New Hanover County at no cost.

In the 1950s it became known as the New Hanover County Airport. In 1988 the airport added "International" to become known as New Hanover County International Airport. On December 17, 1997, the New Hanover County Airport Authority changed the name to Wilmington International Airport.

Piedmont Airlines began commercial flights to Wilmington in February 1948, and used Wilmington as one of its initial crew bases. Its first route was between Wilmington and Cincinnati, Ohio, with stops in Pinehurst, Charlotte, Asheville, the Tri-Cities, and Lexington. Piedmont was the airport's only scheduled carrier as of 1975, with flights to Atlanta, Fayetteville, Jacksonville, Kinston, Myrtle Beach, New Bern, Norfolk, and Washington-National, using YS-11, FH-227 and Boeing 737 aircraft. Piedmont was acquired by USAir in 1989; USAir was renamed US Airways in 1997, and merged with American Airlines in 2013.

In addition to flights to its main regional hub at Charlotte Douglas International Airport, US Airways introduced three daily flights between Wilmington and LaGuardia Airport in New York City during the 2000s following lobbying from the Wilmington community. US Airways also introduced nonstop service to Ronald Reagan Washington National Airport in March 2011. American Eagle began service between Wilmington and Chicago O'Hare International Airport in July 2011 after the airport authority offered two years of waived fees and marketing cost sharing. This route had been actively sought by the local business community for its connections to the West Coast and to Asia. The route was discontinued on April 2, 2012, but reinstated in early 2018.

From April 2025 to January 2026, the airport was an operating base for Avelo Airlines.

ILM was one of four airports along the East Coast which served as an emergency abort landing site for the Space Shuttle. Improvements in the orbiter's braking system reduced the previous 10,000-foot (3,000 m) runway requirement to 7,500 feet (2,300 m) enabling ILM's 8,016-foot (2,443 m) runway to serve the role. ILM has also been used for touch-and-go training flights by United States Air Force VIP aircraft, including the Boeing VC-25 (Air Force One), C-32 and C-40.

Superfund site

A 1,500-square-foot (140 m2) burn pit on the airport property was named a Superfund site on March 31, 1989. The burn pit was built in 1968 and was used until 1979 for firefighter training missions. Jet fuel, gasoline, petroleum storage tank bottoms, fuel oil, kerosene, and sorbent materials from oil spill cleanups were burned in the pit. Up to 500 gallons of fuel and other chemicals were used during each firefighting training exercise. The firefighters in the training missions mainly used water to put out the fires, but carbon dioxide and other dry chemicals were also used. The soil and groundwater was found to have multiple contaminants, including benzene, ethylbenzene, total xylene, 2-methylnaphthalene, phenanthrene, chloroform, 1,2-dichloroethane, and chromium. The site has finished environmental remediation, and the last five-year review for the site was completed in August 2013. According to the EPA the site has been delisted from the national priority list.