Altrusa Institute was founded in Nashville, Tenn., on April 11, 1917, under the direction of Dr. Alfred Durham. It was incorporated on August 21, 1917. Envisioning Altrusa Institute as a chain of national clubs where professional women could exchange ideas, Dr. Durham organized clubs in Nashville; Louisville, Ky.; and Dayton, Ohio. Mamie L. Bass furthered the dream, helping to organize a club in Indianapolis, Ind., and leading the effort to make Altrusa a classified service organization for women at Altrusa's first international convention in 1918.

Now a classified service organization, the Altrusa Institute renamed itself the National Association of Altrusa Clubs and adopted by-laws that laid the groundwork for today’s Altrusans. Soon after, Mamie L. Bass created the Principles of Altrusa, which defined Altrusa as "a builder of women" and an organization based on merit and accomplishment. The Principles were officially adopted in 1921 along with a major club building effort. By 1922, Altrusa had 20 clubs.

Altrusa became international on June 19, 1935, when it organized its first club in Mexico. From that first step over U.S. borders in 1935, Altrusa moved into Puerto Rico, Chile, Ecuador, Mexico, India, Korea, Russia, Ukraine, Ireland, Great Britain, Bermuda, Canada, and New Zealand. In 1946, Altrusa sent its first representative to the United Nations.

In the 1960s, Altrusans began to look to America’s youth as the future of Altrusa. In 1966, ASTRA was established. ASTRA service clubs target young women ages 13 to 21 and encourage them in their education, professions and service to society. Expanding on its commitment to youth, Altrusa adopted literacy as its ongoing service in 1977, and in 1997, Altrusa Foundation adopted Camp Safe Haven for children with HIV/AIDS.

Today there are Altrusa Clubs in 19 nations around the world: Bermuda, Canada, Chile, Dominican Republic, Ecuador, El Salvador, England, Guatemala, India, Ireland, Korea, Mexico, New Zealand, Philippines, Puerto Rico, Russia, Scotland, Ukraine, and the United States.