National account management evolved in the 1960s out of the need for sellers to devote significant corporate resources to large, complex accounts having special requirements. Historically, accounts that qualified for differential status were characterized by several common traits: a centralized, coordinated purchasing organization with multi-location purchasing influences, a complex buying process, large purchases, and a need for special services.

Today, strategic account management is practiced on the national, regional, multinational and global levels according to seller and buyer organizational characteristics and operational behavior. The practice of strategic account management is now a profession, an ongoing focus of academic study and a matter of keen practical interest to companies seeking to survive current economic conditions, achieve competitive advantage and create future growth. Above all, companies are striving to preserve those customer relationships that are of strategic importance to their firm's future financial health.

Installing a comprehensive strategic account management approach within a company requires significant financial investment, long-term focus and multi-functional capabilities along with substantial restructuring of the sales organization. Critical success factors for SAM include organizational alignment, senior management commitment, processes and systems for communications and knowledge management, selecting strategic accounts, account planning, relationship and program metrics and the potential to realize the benefits of a mutually profitable strategic account relationship.

A strategic account manager (also titled major account manager, key account manager, national / global account manager) is the guardian of the strategic customer relationship, orchestrating the deployment of corporate-wide resources to provide comprehensive product, service and solutions to the strategic account. This position is overseen by a VP / director of strategic accounts (also titled manager of strategic accounts, VP of sales) and senior executive sponsors, all of whom support and empower the strategic account manager in their respective roles. Other support personnel may include account teams of varying composition.