Atherstone Town

The original medieval football game honoured by the annual event was held in Atherstone in 1199, during which teams from Warwickshire and Leicestershire competed to win a bag of gold offered as a prize by King John. This original "Match of Gold", as it became known, was won by Warwickshire. The Ball Game was once one of many such games held in towns throughout England, but is presently one of three that continue to be held over Shrovetide, the other two being the Royal Shrovetide Football match in Ashbourne, Derbyshire, and Scoring the Hales in Alnwick, Northumberland.

Medieval football matches were more common before the 20th century, but their violent nature led the government of the time to pass the Highway Act 1835 to prevent it being played in the streets, although games continued to take place in Atherstone. In 1901, an attempt by police and local authorities to also have the Atherstone game banned was rejected by parish councillors. The game continued throughout World War I and World War II, even though shopkeepers had difficulty sourcing wood to board up their premises, and leather for the ball was difficult to obtain. The Cheshire family, who won the game during World War II, filled the ball with cigarettes and tobacco to send to British troops of the Eighth Army, who were stationed in the Sahara desert. Before the 1970s the game was played throughout the town, but was restricted to Long Street because the ball frequently ended up in the Coventry Canal. In 1986, a public meeting was held to determine the game's future after that year's event got out of hand. The outcome of this meeting was the formation of a Ball Game committee, which now has responsibility for organising the event. The 2001 foot-and-mouth outbreak almost led to that year's game being cancelled, but it was given the go-ahead at the last minute, becoming the only such game of its type to be held in 2001 as the Ashbourne game did not take place. The 2005 game marked the first occasion on which money was raised for charity, with funds donated to the Indian Ocean Tsunami Appeal.

In 2012, and following cuts to policing that would reduce the number of officers present at the game, a new company was formed to help the game comply with health and safety regulations. An 18-year-old competitor from the nearby town of Nuneaton was also treated in hospital after being knocked unconscious during the final minutes of the game. Violence broke out at the 2019 game and committee chairman Rob Bernard later suggested those responsible for the violence threatened the game's future, stating: "In the past, when things have got out of hand, we've put it out there that the future of the Ball Game is under threat and it calms down a bit the following year... But then it comes back again. It is the nature of it." Following the 2019 game, a clip of participants fighting received 3.4 million views on Facebook, and a report in the Daily Mirror newspaper claimed that a man's ear had been ripped off during the fracas. However, no such casualties were reported either by police or ambulance officials.

The 2020 game, held on 25 February of that year, was abandoned around halfway through the match when a steward was taken ill, having collapsed from a heart attack at the town's Conservative Club. He was treated at the scene by first responders – special constables and paramedics from West Midlands Ambulance Service – before being airlifted to hospital, where he underwent medical procedures. A JustGiving page was subsequently established to provide financial help for his family.

In 2021, the game was cancelled for the first time in its 821‑year history due to the ongoing COVID-19 pandemic. It returned in March the following year. The 2023 game was reported to have been the scene of a number of violent incidents, including a mass brawl where several kicks and punches were thrown, and during which damage was caused to a William Hill bookies. This prompted Warwickshire Police to issue a warning prior to the 2024 game that "Levels of violence witnessed last year will not be tolerated".