In 1946, Virginia's General Assembly passed legislation creating the Peninsula Airport Commission (PAC) to determine a location for and establish a new airport for the cities of Newport News and Hampton. An agreement was reached with the US War Asset Administration in 1947 to transfer 924 acres (3.7 km2) of the former Camp Patrick Henry, a World War II US Army base, to the PAC as the site for the new airport. A Nike missile air defense base, known as N-85, still exists on the property, though abandoned since the mid-1960s.

The airport was originally named Patrick Henry Airport, its code PHF representing Patrick Henry Field. The first runway was 2–20, a 3,500-foot (1,100 m) runway, followed by 6–24 (later redesignated as 7–25). Airline service began in November 1949 on Piedmont Airlines and Capital Airlines.

In 1951 the passenger terminal was damaged by a fire. An upgraded traffic control tower was built and Runway 6–24 was extended to 5,000 feet (1,500 m) in 1952; a new passenger terminal opened in 1955.

National Airlines arrived at PHF in 1955 and by 1964 was operating all of its flights from the airport with Lockheed L-188 Electra turboprops with service to Washington DC National Airport, New York JFK Airport, New York Newark Airport, Baltimore, Philadelphia and nearby Norfolk. Allegheny Airlines (later renamed USAir) arrived in 1966. United Airlines (which had acquired and merged with Capital Airlines), National, Allegheny and Piedmont all operated jets to PHF with the first jets being operated by National with Boeing 727s in 1966 (runway 6 had been extended from 5600 to 6100 ft by then). Both runways were extended to their current lengths of 6526 feet (1989 m) Runway 2–20, and 8003 feet (2439 m) Runway 7–25.

The airport became Patrick Henry International Airport in 1975. According to the Official Airline Guide, four airlines were serving the airport in early 1976 with nonstop or direct, no change of plane flights including Allegheny with McDonnell Douglas DC-9-30 jets from Boston, Hartford, Philadelphia and Providence; National with Boeing 727-100 and Boeing 727-200 jets from New York JFK Airport, Washington DC National Airport and nearby Norfolk; Piedmont with NAMC YS-11 turboprops from Atlanta, Columbus, OH, Florence, SC, New Bern, NC, Norfolk, Parkersburg, WV, Richmond, VA, Roanoke, VA and Washington DC National Airport; and United with Boeing 727-100 and Boeing 737-200 jets from Atlanta, Chicago O'Hare Airport, Moline, IL and Washington DC National Airport. A US Customs facility was added to the terminal to allow international arrivals (airline and corporate). The airport currently covers 1,800 acres (7.3 km2), most of it in the city of Newport News and nearly half of the airfield with runways 20 and 25 in York County.

When the United States Congress deregulated the airlines in 1978, many airlines serving Patrick Henry Airport consolidated their southeast Virginia services at other airports, and Patrick Henry International Airport lost most of its jet service. National pulled out in 1978. In late 1978, Piedmont was operating Boeing 737-200 jets nonstop to New York JFK Airport, one stop Boeing 737-200 jets to New York LaGuardia Airport via Norfolk, and also nonstop NAMC YS-11 turboprops to Washington National Airport but was no longer serving the airport by the fall of 1979. Allegheny Commuter had replaced Allegheny jet service by this same time in 1979 with code sharing flights then being operated with small commuter Beechcraft and Short 330 turboprop aircraft. Also by the fall of 1979, United was the only airline operating mainline jet service into the airport with Boeing 727-200 and Boeing 737-200 flights nonstop from Chicago O'Hare Airport, Washington DC National Airport, Baltimore and nearby Norfolk; however, United then ceased serving the airport with mainline jets in 1981. United Express operated code sharing flights on behalf of United from the late 1980s through the 1990s with British Aerospace BAe Jetstream 31 and Embraer EMB-120 Brasilia turboprops with nonstop service from the United hub located at Washington DC Dulles Airport. The airport led the nation in air service decline after deregulation and was facing severe financial difficulty.

The turnaround began with the hiring of Charles J. Blankenship as executive director in 1984. Blankenship implemented a strategic plan of developing a business park named Patrick Henry Commerce Center and a marketing campaign to attract air carriers. By 1985 the airport had the distinction of being America's fastest-growing airport. That success was repeated in 1986.

On December 19, 1980, the Daily Press reported a committee authorized by the PAC recommended that the airport change its name to "Newport News/Williamsburg International" to then-Executive Director Michael White. This change would not take place until ten years later. At the time, the Commission members represented the cities of Newport News, Hampton, and Williamsburg, as well as James City County and York County.