The arena was built on a downtown site as a replacement for Edgerton Park Arena, bounded by Exchange Boulevard on the west, East Broad Street on the north, the Genesee River on the east and Court Street on the south. The property was formerly the home of the Kimball Tobacco Co. and other retail buildings. Originally named the Rochester Community War Memorial, the arena opened on October 18, 1955. The building included a full stage on the south end and an exhibition hall located on the basement level. One of the members of the construction team was a young Robert Marella, who later achieved fame as professional wrestler Gorilla Monsoon. The arena's first tenant was the Rochester Royals NBA basketball team, who played their final two seasons in Rochester at this arena. They were joined by the Americans the next year, who have played in the arena for 63 consecutive seasons.
On March 13, 1996, renovations to expand the arena took place, eliminating the permanent stage at the south end of the building. On July 24, 1998, Blue Cross Blue Shield and City officials announced that the name of the renovated arena would be Blue Cross Arena at the War Memorial. On September 18, 1998, the arena reopened to the public during a formal ribbon cutting/rededication ceremony. DeWolff Partnership Architects completed the project as Architects of Record with Rossetti Architects in a consultant relationship. C.E. DeWolff, Senior Partner of DeWolff Partnership, Geno Rossetti of Rossetti Architects, were Design Associates who collaborated on features of the design. In 2018, the city terminated the arena management contract with long term operator SMG who had been running the arena since 2000. In July 2018, the city reached an agreement with Pegula Sports and Entertainment, owners of the Americans, Buffalo Sabres and Buffalo Bills and operators of KeyBank Center in Buffalo to operate the arena beginning on August 1, 2018. Shortly after the Pegula takeover the arena received updates of a new center scoreboard, a new ribbon board at the stage end of the arena and enhancements to the audio and video equipment. There are plans for expansion along the Exchange Boulevard side of the arena that will make room for additional office space and improved locker room facilities as well as planned upgrades to the bathrooms, new concessions and a restaurant.
Blue Cross Arena's portable stage, which measures 80 feet deep by 80 feet wide, is said to be deeper than, and is nearly the same size as, the proscenium stage at Radio City Music Hall across the state in New York City.