The Miss Missouri USA competition is the pageant that selects the representative for the state Missouri in the Miss USA pageant. It is directed by Vanbros and Associates, based in Lenexa, Kansas. In 1993, Missouri joined the Vanbros group of state pageants for the Miss USA and Teen USA system.

Missouri has had only one Miss USA, Shandi Finnessey, who placed as 1st runner-up to Jennifer Hawkins of Australia in the Miss Universe 2004 pageant. The most recent placement was Mikala McGhee in 2022, placing Top 16. Three Miss Missouri USAs have competed at Miss America, including Finnessey. Nine former Miss Teen USA delegates have also won the title one as former Miss Illinois Teen USA, equalling Indiana and Virginia for the most crossovers, although both Indiana and Missouri have had titleholders who competed in a different state at Miss Teen USA.

Shae Smith of Bolivar was crowned Miss Missouri USA 2025 on May 11, 2025 at The Mansion Theater in Branson. She represented Missouri at Miss USA 2025.

Missouri holds a record of 27 placements at Miss USA.