
In 1924, the AHSAA joined the National Federation of State High School Athletic Associations, the national leadership organization for high school sports. The National Federation is a service and regulatory organization that controls interstate athletic events and enables the 50-state association members to secure the benefits of cooperative action through pooling and coordinating the ideals of high school athletic administration.
The AHSAA sponsors state championships programs in baseball, boys' and girls' basketball, boys' and girls' cross country, football, boys' and girls' golf, boys' and girls' track and field, boys' and girls' soccer, softball, boys' and girls' swimming and diving, boys' and girls' tennis, volleyball, and wrestling. The AHSAA classifies member schools in a six-tier classification system based on enrollment—1A through 6A—with 6A containing the schools with the largest enrollment. Classification for private school members is likewise based on enrollment.

Sellers Stough served as the first director on a part-time basis. Cliff Harper became the first full-time AHSAA head in 1948, with the establishment of a state office in Montgomery, and completed the first organization of high school athletics statewide, also in 1948. Herman L. Scott succeeded Harper as executive director in 1966. He helped facilitate the merger of the racially segregated high school athletic programs in the state in 1968 as mandated by a court order. (Black schools had competed in the Alabama Interscholastic Athletic Association.) Scott also organized and conducted the first state football championship program in 1966 and expanded girls' athletic programs. He also set in motion the creation of the Alabama High School Sports Hall of Fame, which had its first induction class in 1991.

Steve Savarese became the fourth full-time executive director August 1, 2007. Savarese created partnerships with the Jason Foundation and the Alabama Sports Foundation (ASF) in 2008. The Jason Foundation Inc., a non-profit organization, addresses the problem of youth suicide. This relationship resulted in the nation's first statewide provision allowing an athletic association's membership access to the Jason Foundation's youth suicide prevention training.
An integral part of the AHSAA is the Alabama High School Athletic Directors & Coaches Association (AHSADCA), which is composed of coaches and administrators. This organization works in conjunction with the AHSAA in the professional development of coaches and athletic directors and administers all of the organization's all-star events, such as the Alabama-Mississippi football and basketball all-star games. AHSADCA also holds annual seminars to discuss drug testing policies and procedures, current sports medicine issues, Title IX responsibilities, National Collegiate Athletic Association (NCAA) requirements, and legal issues in athletics.

Whereas the AHSAA is the primary sanctioning organization for high school sports in Alabama (and the only one allowed for public schools), it is not the only such organization. The Alabama Independent Schools Association sanctions athletics for approximately 60 private schools throughout the state. Other smaller organizations, such as the National Christian Sports Conference and the Alabama Christian Athletic and Academic Association, sanction sports from smaller Christian schools and home schools, most commonly in eight-man football.