Prior to 1969, the basketball team of the University of Houston hosted their home games at high school arenas such as Jeppesen Gym and Delmar Field House. Hofheinz Pavilion was meant to replace these venues as a permanent location.

The first athletic event at Hofheinz Pavilion was held on December 1, 1969 when the Houston Cougars men's basketball team defeated Southwestern Louisiana 89–72 before a crowd of 7,000.

When the team relocated from San Diego in 1971, the NBA's Houston Rockets used the venue as their home arena, although selected games were played at the Astrodome. The Rockets played at Hofheinz Pavilion during their first four seasons in Houston until the construction of The Summit was completed in 1975.

On March 5, 1990, Hofheinz Pavilion hosted its largest number of spectators to date when a crowd of 10,660 attended a men's basketball game in which Houston beat Texas.

A new ceiling, lighting and sound system were installed in 1991. Through a donation by alumni John and Rebecca Moores in 1992, the basketball locker rooms were enlarged and equipped with personal lockers for each player. Also added was a meeting area and lounge furnished with couches, a color television, a stereo sound system and a pull-down projection screen.

In 1995, the court was renamed to "Guy V. Lewis Court at Hofheinz Pavilion" in honor of College Basketball Hall of Fame coach Guy V. Lewis.

In 1998, Hofheinz Pavilion again underwent a renovation as part of a capital improvement campaign undertaken by the university to upgrade its athletic facilities. In its original format Hofheinz Pavilion had a seating capacity of 10,000. As part of the renovation, a ring of luxury suites was added to the top of the seating bowl. This addition necessitated the removal of 1,500 seats, reducing capacity to 8,479. The new Connor Uni-Force Flooring System was installed in October 2004. In June 2010, the University of Houston announced its intention to undergo a $40 million renovation and expansion to Hofheinz Pavilion after a four-month feasibility study conducted by AECOM. This would mark the largest single financial investment to the arena to that point.

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