The governance of the Union alternates every two years between the divisions as described in the Memorandum of Cooperation between the two divisions and the Union's Statutes . Currently, the members of the IUHPST Board are:

President. Nancy CARTWRIGHT (United Kingdom & United States of America; President, DLMPST)
Vice President. Marcos CUETO (Brazil; President, DHST)
Secretary General. Benedikt LÖWE (The Netherlands, Germany, & United Kingdom; Secretary General, DLMPST)
Treasurer. Pierre Édouard BOUR (France; Treasurer, DLMPST)

The Union is currently in the process of updating the Statutes to have more balance between the two Divisions in the IUHPST Board, The new Statutes have already been approved by the DHST General Assembly in Prague (held virtually) on 31 July 2021 and will be considered by the DLMPST General Assembly in Buenos Aires in July 2023. In anticipation of the statutory change, Liesbeth DE MOL (France; Secretary General, DHST) and Milada SEKYRKOVÁ (Czech Republic; Treasurer, DLMPST) have been invited to be non-voting members of the IUHPST Board.

History. Among the past presidents of the Union were Wilfrid HODGES (DLMPS, United Kingdom, 2010-2011), Liu DUN (DHST, China, 2012-2013), Elliott SOBER (DLMPS/DLMPST, United States of America, 2014-2015), Efthymios NICOLAIDIS (DHST, Greece, 2016-2017), Menachem MAGIDOR (DLMPST, Israel, 2018-2019), and Michael OSBORNE (DHST, United States of America, 2020-2021).