The Panamerican Triathlon Confederation was founded on May 9, 1992, at the first PATCO Congress on the island of San Andrés, Colombia. Development of the Confederation began three years earlier, at the inaugural ITU Congress in Avignon, France, in meetings attended by now ITU President Marisol Casado.

The first PATCO Triathlon Championships were held in Puerto Vallarta, Mexico on August 29, 1997. The inaugural event was won by Mexico's Eligio Cervantes and Canada's Carol Montgomery. Puerto Vallarta also hosted a Pan American Cup in 2009 and will host the 2010 PATCO Championship on 16 October.

There are currently 38 National Federation members of PATCO.