Around the World War II era until the early 1970s, longer range land plane air service to Ketchikan including flights to Seattle were operated via an old military airfield located approximately 20 air miles to the south on Annette Island. Aircraft operated into the Annette Island Airport (ANN) for flights in the local southeast Alaska area included the Grumman Goose and Consolidated PBY Catalina with these amphibian aircraft being utilized to link the airport with the Ketchikan Harbor Seaplane Base. Longer range flights serving Annette Island were operated with Douglas DC-4 prop aircraft flown by Pan American World Airways during the 1940s followed by Douglas DC-6 and Boeing 377 Stratocruiser aircraft. Other service into the Annette Island Airport included Lockheed Constellation propliners flown by Pacific Northern Airlines during the 1950s and Boeing 707 jetliners flown by Pan Am in the early 1960s. In addition, Annette Island was served with Boeing 720 jetliners operated by Pacific Northern and successor Western Airlines later during the 1960s. Alaska Airlines also operated into Annette Island Airport prior to moving its jet service to Ketchikan International Airport with the opening of this new airfield.

The current airport was opened on August 4, 1973, and was dedicated on the following day. The airport opening was the culmination of an effort by local residents, a 1965 study by the Alaska State Division of Aviation, another study in 1967 choosing the current site on Gravina Island, and land clearing in 1969. One of the first airlines to serve the new airport was Alaska Airlines which inaugurated the first jet service from Seattle to Ketchikan International Airport on August 4, 1973, with a Boeing 720 jetliner. Alaska Air primarily operated Boeing 727-100, 727-200 and 737-200 jetliners (including 737 passenger/cargo Combi aircraft) into the airport before switching to later model Boeing 737 jets. Alaska Airlines has flown from the airport for over 40 years and also operated Grumman Goose and Super Catalina amphibian aircraft into the seaplane base serving Ketchikan prior to the opening of the airfield in 1973. Other airlines that operated jet service into the airport in the past included Wien Air Alaska and MarkAir with both air carriers flying Boeing 737 jets as well as Western Airlines operating Boeing 727-200 jetliners.