According to tradition, after the Buddha's passing, the tooth relic was preserved in the Indian kingdom of Kalinga. When Kalinga came under attack, King Guhasiva entrusted the relic to his children, Princess Hemamali and Prince Dantha, to carry it to safety. Hemamali concealed the tooth in her hair for the journey across the sea. They arrived in Sri Lanka during the reign of Sirimeghavanna of Anuradhapura, who ruled from 301 to 328 CE, and the king enshrined the relic in Meghagiri Vihara, known today as Isurumuniya. From that moment, the tooth's custodianship became inseparable from sovereignty. As kingdoms rose and fell across the island, from Anuradhapura to Polonnaruwa to Dambadeniya to Gampola to Kotte, the relic traveled with the seat of power, always kept close to the throne.

The relic's journey to its current home was not straightforward. During the reign of Dharmapala of Kotte, the tooth was hidden inside a grinding stone at Delgamuwa Vihara in Ratnapura. When the Portuguese invaded Kandy in 1603, it was spirited away to Meda Mahanuwara in the Dumbara hills. King Rajasinha II eventually recovered it, either restoring the original temple or building anew. The distinctive octagonal Paththirippuwa tower and the surrounding moat were added during the reign of Sri Vikrama Rajasinha, the last king of Kandy. Royal architect Devendra Moolacharya designed the Paththirippuwa, which the king originally used for leisure before dedicating it to the relic. Today it houses the temple's library, an elegant structure of Kandyan craftsmanship overlooking the lake.

The architecture of the Sri Dalada Maligawa layers devotion in stone, wood, and gold. A brick wall runs along the moat and Bogambara Lake in a pattern known as the water waves wall. Stone elephants flank the entrance, and a Makara Torana arch with guardian stones crowns the staircase. Inside, the Hewisi drummers' chamber stands before the main shrine, whose two stories are called Palle Malaya and Udu Malaya. The doors of the upper shrine are carved ivory. Beyond them lies the Handun Kunama, the inner sanctum where the tooth rests. A golden canopy, erected in 1987 by Prime Minister Ranasinghe Premadasa, covers the main shrine, and a golden fence encircles the complex. The relic itself sits within seven nested golden caskets shaped like a stupa, each studded with precious stones. A separate procession casket, carried during the annual Kandy Esala Perahera, is displayed in the same chamber.

The temple is not a museum. Bhikkhus from the Malwathu and Asgiri chapters conduct worship in the inner chamber at dawn, noon, and evening. On Wednesdays, the relic receives a symbolic bathing called Nanumura Mangallaya, a herbal preparation of scented water and fragrant flowers, and the resulting holy water is distributed to the faithful, who believe it holds healing powers. The grandest expression of devotion is the Kandy Esala Perahera, an annual procession of costumed elephants, traditional dancers, and drummers that winds through the streets of Kandy to honor the sacred relic. It is one of the oldest and most spectacular religious festivals in Asia, drawing pilgrims and visitors alike into a city already dense with reverence.

The temple has survived centuries of colonial pressure and modern violence. The Portuguese sought to destroy the relic during their occupation, and the Kandyan kings resorted to desperate measures to keep it safe. In 1989, the Janatha Vimukthi Peramuna attacked the temple during an insurrection. In 1998, the Liberation Tigers of Tamil Eelam detonated a truck bomb that damaged the facade and killed seventeen people. Both attacks targeted the most sacred site in Sri Lanka, understanding that to strike the temple was to strike at the heart of Sinhalese identity. Both times, the relic survived. The temple was restored, the rituals resumed, and the faithful returned. In April 2025, a public exposition of the tooth drew roughly 450,000 devotees in a single day, a reminder that the power this small relic commands over the human heart has not diminished.