The MTV Video Music Award for Best Rock was first given out in 1989, one of the four original genre categories added to the VMAs that year. In its first year, the award was called Best Heavy Metal Video, and from 1990 to 1995, it was renamed Best Metal/Hard Rock Video. The category underwent a third, brief name change in 1996, when it was renamed Best Hard Rock Video. In 1997, the award acquired its most enduring name, Best Rock Video, which it retained until 2016. The following year, the word "Video" was removed from all genre categories at the VMAs, giving this award its current name: Best Rock.

The 1989 MTV Video Music Awards aired live on September 6, 1989, honoring the best music videos from April 2, 1988, to June 1, 1989. The show was hosted by Arsenio Hall at the Universal Amphitheatre in Los Angeles.