The United States recognized the Former Yugoslav Republic of Macedonia on February 9, 1994. At the same time, the United States announced its intent to establish full diplomatic relations with the Former Yugoslav Republic of Macedonia.

The United States established a Liaison Office in Skopje on December 3, 1993. Robert L. Norman was the Acting Principal Officer.

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On September 13, 1995, U.S. President William J. Clinton announced that he had been in correspondence with President of the Former Yugoslav Republic of Macedonia Kiro Gligorov to establish diplomatic relations, and announced that “I have received his positive response and can confirm that diplomatic relations now exist between our two countries.”

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Macedonia achieved independence in 1991 with the peaceful breakup of Yugoslavia. Recognition was delayed because of Greece’s objection to Macedonia’s use of “Macedonia,” and the country was initially recognized as the “Former Yugoslav Republic of Macedonia.” The United States recognized FRYM in 1994 under the provisional designation and began referring to Macedonia by its constitutional name, Republic of Macedonia, in 2004. Macedonia and Greece signed the Prespa Accord in June 2018 which, among other things, resolved the decades-long dispute over the Republic of Macedonia's name. In February 2019, Macedonia's name changed to the Republic of North Macedonia.

On July 29, 1996, Christopher R. Hill presented his credentials as the first U.S. Ambassador to the Former Yugoslav Republic of Macedonia.