| No. | Portrait | Name (Birth–Death) | Term of office | Appointed by (term) | Ref. |
| Took office | Left office | Time in office |
| 1 | | John M. Woodworth (1837–1879) | March 29, 1871 | March 14, 1879 | 7 years, 350 days | Ulysses S. Grant (1869–1877) | |
| 2 | | Commodore John B. Hamilton (1847–1898) | April 3, 1879 | June 1, 1891 | 12 years, 59 days | Rutherford B. Hayes (1877–1881) | |
| 3 | | Commodore Walter Wyman (1848–1911) | June 1, 1891 | November 21, 1911 | 20 years, 173 days | Benjamin Harrison (1889–1893) | |
| 4 | | Commodore Rupert Blue (1868–1948) | January 13, 1912 | March 3, 1920 | 8 years, 50 days | William Howard Taft (1909–1913) | |
| 5 | | Rear Admiral Hugh S. Cumming (1869–1948) | March 3, 1920 | January 31, 1936 | 15 years, 334 days | Woodrow Wilson (1913–1921) | |
| 6 | | Rear Admiral Thomas Parran (1892–1968) | April 6, 1936 | April 6, 1948 | 12 years, 0 days | Franklin D. Roosevelt (1933–1945) | |
| 7 | | Rear Admiral Leonard A. Scheele (1907–1993) | April 6, 1948 | August 8, 1956 | 8 years, 124 days | Harry S. Truman (1945–1953) | |
| 8 | | Rear Admiral Leroy E. Burney (1906–1998) | August 8, 1956 | January 29, 1961 | 4 years, 174 days | Dwight D. Eisenhower (1953–1961) | |
| 9 | | Luther Terry (1911–1985) | March 2, 1961 | October 1, 1965 | 4 years, 213 days | John F. Kennedy (1961–1963) | |
| 10 | | William H. Stewart (1921–2008) | October 1, 1965 | August 1, 1969 | 3 years, 304 days | Lyndon B. Johnson (1963–1969) | |
| – | | Rear Admiral Richard A. Prindle (c. 1926–2001) Acting | August 1, 1969 | December 18, 1969 | 139 days | Richard Nixon (1969–1974) | |
| 11 | | Jesse L. Steinfeld (1927–2014) | December 18, 1969 | January 30, 1973 | 3 years, 43 days | |
| – | | Rear Admiral S. Paul Ehrlich Jr. (1932–2005) Acting | January 31, 1973 | July 13, 1977 | 4 years, 163 days | |
| 12 | | Vice Admiral Julius B. Richmond (1916–2008) | July 13, 1977 | January 20, 1981 | 3 years, 191 days | Jimmy Carter (1977–1981) | |
| – | | Rear Admiral John C. Greene (1936–2016) Acting | January 21, 1981 | May 14, 1981 | 113 days | Ronald Reagan (1981–1989) | |
| – | | Edward Brandt Jr. (1933–2007) Acting | May 14, 1981 | January 21, 1982 | 252 days | |
| 13 | | Vice Admiral C. Everett Koop (1916–2013) | January 21, 1982 | October 1, 1989 | 7 years, 253 days | |
| – | | Admiral James O. Mason (1930–2019) Acting | October 1, 1989 | March 9, 1990 | 159 days | George H. W. Bush (1989–1993) | |
| 14 | | Vice Admiral Antonia Novello (born 1944) | March 9, 1990 | June 30, 1993 | 3 years, 113 days | |
| – | | Rear Admiral Robert A. Whitney (born 1935) Acting | July 1, 1993 | September 8, 1993 | 69 days | Bill Clinton (1993–2001) | |
| 15 | | Vice Admiral Joycelyn Elders (born 1933) | September 8, 1993 | December 31, 1994 | 1 year, 114 days | |
| – | | Rear Admiral Audrey F. Manley (born 1934) Acting | January 1, 1995 | July 1, 1997 | 2 years, 180 days | |
| – | | Rear Admiral J. Jarrett Clinton (1938–2023) Acting | July 2, 1997 | February 12, 1998 | 226 days | |
| 16 | | Admiral David Satcher (born 1941) | February 13, 1998 | February 12, 2002 | 3 years, 364 days | |
| – | | Rear Admiral Kenneth P. Moritsugu (born 1945) Acting | February 13, 2002 | August 4, 2002 | 172 days | George W. Bush (2001–2009) | |
| 17 | | Vice Admiral Richard Carmona (born 1949) | August 5, 2002 | July 31, 2006 | 3 years, 360 days | |
| – | | Rear Admiral Kenneth P. Moritsugu (born 1945) Acting | August 1, 2006 | September 30, 2007 | 1 year, 60 days | |
| – | | Rear Admiral Steven K. Galson (born 1956) Acting | October 1, 2007 | October 1, 2009 | 2 years, 0 days | |
| – | | Rear Admiral Donald L. Weaver Acting | October 1, 2009 | November 3, 2009 | 33 days | Barack Obama (2009–2017) | |
| 18 | | Vice Admiral Regina Benjamin (born 1956) | November 3, 2009 | July 16, 2013 | 3 years, 255 days | |
| – | | Rear Admiral Boris Lushniak (born 1961) Acting | July 17, 2013 | December 18, 2014 | 1 year, 154 days | |
| 19 | | Vice Admiral Vivek Murthy (born 1977) | April 22, 2015 | April 21, 2017 | 1 year, 364 days | |
| – | | Rear Admiral Sylvia Trent-Adams (born 1965) Acting | April 21, 2017 | September 5, 2017 | 137 days | Donald Trump (2017–2021) | |
| 20 | | Vice Admiral Jerome Adams (born 1974) | September 5, 2017 | January 20, 2021 | 3 years, 137 days | |
| – | | Rear Admiral Susan Orsega Acting | January 20, 2021 | March 24, 2021 | 63 days | Joe Biden (2021–2025) | |
| 21 | | Vice Admiral Vivek Murthy (born 1977) | March 24, 2021 | January 20, 2025 | 3 years, 302 days | |