FMRAI was formed in April 1963 at Hyderabad with an aim to improve the living conditions of Medical Representatives. It has travelled a long way since then and today it is one of the militant trade unions in the country. FMRAI is the only national organisation for the Sales Promotion Employees with 19 affiliated state units representing all the States and Union territories, with 388 sub-units in the country. Its membership has crossed one lakh in 2017 and continuously growing. FMRAI associates its activities with several central trade unions and industrial federations of the country and its members participate in the united working-class movements.

Based on FMRAI's demand to the Govt. In 1976, the Sales Promotion Employees' (Conditions of Service) Act was enacted. FMRAI demanded the Govt. to extend the benefit of the Act to sales representatives of all industries. Govt. has extended the benefit of the law only for 10 other industries and FMRAI is pursuing further extension to the SPEs of all industries. Many companies, including multinational drug companies, have recognized FMRAI as a trade union for their field workers and regular wage agreements are signed. Periodical meetings are also held bilaterally to redress the grievances of the field workers.

Movement is carried out for notification of working rules, implementation of labour laws and other general issues with the Central and State Governments. Company-wise council movement concentrates on establishment of rights in all companies. FMRAI is strongly fighting against the effects of newer forms of attacks on the jobs, service and working conditions of the Sales Promotion employees by the managements, arising out of the new situation in the pandemic era and because of the Government's anti-labour policies.

FMRAI is associated with Jan Sasthya Abhiyan, Peoples Health Movement-India, All India People's Science Network (AIPSN), and actively works in the areas of health and pharmaceuticals. FMRAI continuously campaigns on various health and medicine related issues. FMRAI also maintains good relations with associations of doctors and trade organisations. FMRAI has several publications on the health and drug situation of India. FMRAI publishes its organ 'FMRAI News' every month which has a circulation of more than 50000 issues.