The grade of Fellow first appeared in the AIEE constitution of 1912. In that year, the AIEE revised its membership structure and established the grade of Fellow for those engineers who had demonstrated outstanding proficiency and had achieved distinction in their profession. Potential Fellows had to be at least thirty-two years of age, with a minimum of ten years' experience. When the IRE established its Fellow grade in 1914, the requirements were clearly modeled on those of the AIEE. Much of the wording in the relevant sections of the IRE constitution is identical to the corresponding wording in the AIEE constitution.

For the first several years after the establishment of the Fellow grade, both the AIEE and the IRE allowed members to make direct application for transfer to Fellow. In both cases, applications had to be accompanied by references from five existing Fellows and required the approval of the Board of Directors. In 1939, the IRE modified its procedure to make admission or transfer to the Fellow grade possible only by direct invitation of the Board of Directors, a policy it maintained until the merger in 1963. In 1938, the AIEE modified its constitution to provide that "Applications to the grade of Fellow shall result only from a proposal of five members or Fellows." In 1951, the AIEE prohibited applications for Fellow grade altogether, and adopted a policy of direct invitation similar to that of the IRE.

As noted above, numerous electrical engineers were members of both the AIEE and the IRE, and many of them became Fellows of both organizations. When the two institutes merged in 1963, all AIEE and IRE Fellows automatically became Fellows of the IEEE. In 1942, the IRE had begun to issue citations to new Fellows, briefly describing their accomplishments. The AIEE followed suit in 1952, and the IEEE continued the practice after the merger.

As it stands today, the IEEE Grade of Fellow is conferred by the Board of Directors upon a person with an extraordinary record of accomplishments in any of the IEEE fields of interest. The total number selected in any one year does not exceed one-tenth of one percent of the total voting Institute membership. Each new Fellow receives a beautifully matted and framed certificate with the name of the Fellow and a brief citation describing the accomplishment, a congratulatory letter from the incoming IEEE president and a gold sterling silver Fellow lapel pin with antique finish.