A match devised by on-air WWE Raw General Manager Eric Bischoff, it made it's first appearance at the 2002 Survivor Series pay-per-view. Hyped as a hybrid between the Royal Rumble, Survivor Series, and War Games (and described as a "steel hell" by one of the builders), the cage is a 16 foot high steel dome, with a diameter of 36 feet, which lowers from the ceiling of the arena. A steel platform runs from the edge of the ring to the cage, so that when a wrestler exits the ring, he is still on an even level as the mat. The chamber reportedly cost $500,000 to build.

Six competitors wrestle in the match, with two starting out the match, and the other four locked in individual cells made of "bullet-proof plexiglass", (two of which were shattered during the course of the match). Every five minutes, one of the chambers are unlocked and another wrestler joins the fray. Elimination occurs by pinfall or submission, and the last man standing wins the match.

Shawn Michaels won the first Elimination Chamber match, defeating Rob Van Dam, Booker T, Kane, Chris Jericho, and Triple H, to win the World Heavyweight Championship.