On October 1, 2018, McDonald's announced that it would remove all artificial preservatives, flavors, and coloring from the Big Mac. The Big Mac is made with two 1.6 oz (45 g) beef patties, a 'special sauce' (similar to Thousand Island dressing), shredded iceberg lettuce, one processed American cheese slice, two slices of dill pickle, and minced onions, served on a three slice sesame seed bun. The third name, Big Mac, was created by Esther Glickstein Rose, a 21-year-old advertising secretary who worked at McDonald's corporate headquarters in Oak Brook, Illinois. The Big Mac had two previous names, both of which failed in the marketplace: the Aristocrat and the Blue Ribbon Burger. The Big Mac proved popular and it was added to the menu of all U.S. Eat'n Park was the Pittsburgh area's Big Boy franchisee at the time. It was designed to compete with Big Boy Restaurants' Big Boy hamburger. The Big Mac debuted at the McDonald's owned by Delligatti in Uniontown, Pennsylvania, on April 22, 1967, selling for US$0.45 (equivalent to $3.66 in 2021).

It was created in the kitchen of Delligatti's first McDonald's franchise, located on McKnight Road in suburban Ross Township. The Big Mac was created by Jim Delligatti, who operated several McDonald's restaurants in the Pittsburgh area. The Big Mac contains two beef patties, cheese, shredded lettuce, pickles, minced onions, and a Thousand Island-type dressing advertised as 'special sauce', on a three-slice sesame-seed bun. It is one of the company's flagship products and signature dishes. It was introduced in the Greater Pittsburgh area in 1967 and across the United States in 1968. The Big Mac is a hamburger sold by the international fast food restaurant chain McDonald's. †Percentages are roughly approximated using US recommendations for adults.

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