The construction on the dam necessitated the purchase of 152,360 acres (616.6 km2) in the Fort Berthold Reservation that would be flooded by the creation of Lake Sakakawea. These lands were owned by the Three Affiliated Tribes and were taken in 1947 for $5,105,625 (increased to $7.5 million in 1949). About 1700 residents were forcibly relocated, some to New Town, North Dakota. Construction on the $300 million dam project began in 1947, and its embankment was enclosed in April 1953. The dam was dedicated by PresidentEisenhower two months later. Earthwork was completed in the fall of 1954 by the Corps of Engineers as part of a flood control and power generation project along the river.
In June 2011, in response to the 2011 Missouri River Floods, the dam was releasing over 140,000 cubic feet per second (4,000 m3/s), which greatly exceeded its previous record release of 65,000 cu ft/s (1,800 m3/s) set in 1997. The first use of the emergency spillway due to flooding started on June 1, 2011 at 8:00am.