El Sauzal traces its roots to the aboriginal Guanche world. Before the Castilian conquest, this land in the northeast of Tenerife belonged to the menceyato (kingdom) of Tacoronte, one of the nine realms into which the island was divided, and formed part of the Acentejo region, the setting of some of the most decisive episodes of the indigenous resistance. The municipality's very name recalls its original landscape: "Sauzal" refers to the abundance of Canary willows (Salix canariensis) that grew beside the springs and ravines of the area, in a rugged territory that descends from the summits down to the cliffs above the Atlantic.

After the conquest of the island, completed in 1496, the distribution of land and water attracted the first European settlers. Christianity took hold early: in 1505 the Adelantado Alonso Fernández de Lugo, conqueror of La Palma and Tenerife, founded the hermitage of Nuestra Señora de los Ángeles, considered one of the oldest churches on the island. Shortly afterwards the church of San Pedro Apóstol was built, perched on the edge of the cliff with views over the sea, becoming one of the first parishes in Tenerife. El Sauzal's historical prominence reached its peak in 1572, when a plague epidemic forced the seat of the Island Council (Cabildo) to be transferred from La Laguna to the church of San Pedro: during those months, the small town became the political and administrative centre of the island.

El Sauzal's prosperity was tied to wine from early on. The climate, volcanic soils and the orientation of its slopes made the Acentejo region one of the great wine-growing areas of Tenerife, whose vintages (the famous "Canary wines") were exported to Europe. In this context, around the mid-17th century the Seville merchant Simón de Herrera Leiva acquired land and built the Hacienda de San Simón, known as the Quinta de San Simón, a complete agricultural estate with cellars, wine presses, a manor house and workers' dwellings arranged around a courtyard. That 17th-century mansion is today the Casa del Vino de Tenerife, restored and opened to the public in 1995 as a museum, wine cellar and emblem of the island's wines.

El Sauzal is also the birthplace of one of the most venerated religious figures in the Canary Islands: Sor María de Jesús de León y Delgado, affectionately known as "la Siervita." She was born in the municipality on 23 March 1643, into a humble family of ancient lineage, and in 1668 entered as a lay sister the Dominican convent of Santa Catalina de Siena in La Laguna. A woman of deep mystical and penitential life, she died on 15 February 1731 at the age of 87. Three years after her death, her body was found incorrupt. Today she rests in the lower choir of that La Laguna convent and, every 15 February, she is exposed to the veneration of hundreds of faithful who come to behold her. Her beatification process began in 1992, and the Church therefore recognises her as a Servant of God (Sierva de Dios).

The town also preserves spots that have made it a destination of landscape and calm. The Parque de los Lavaderos, built around a spring where women once washed their clothes, has been transformed into a garden of native vegetation crossed by fountains and waterfalls, with views of the coast and Mount Teide. A few steps away, the Mirador de la Garañona offers one of the most spectacular panoramas of northern Tenerife, overlooking the Acentejo cliffs and the ocean, amid dragon trees, palms and bougainvillea.

In 1812, under the Constitution of Cádiz, El Sauzal gained the status of a municipality, and in 1985 the Government of the Canary Islands granted it the title of Villa. Today, with around 9,300 inhabitants spread between the town centre and the upper district of Ravelo, El Sauzal combines its agricultural and wine-making heritage with growing tourist appeal, faithful to the image of a whitewashed village perched on the cliff that it has cultivated for centuries.