After the first phase of the Afghan war of 1878-79 AD, the British took control of the northern areas of Balochistan under the Treaty of Gandamak. During 1879-84 AD, efforts were made to extend the British influence over the Khetrans and Musakhels of the, now Musakhel, territory. The Musakhels took part in outrages committed by the Kakars under Shah Jahan in 1884, but surrendered to the British government on the conclusion of the expedition in the same year. On 1st November 1887, the whole area was declared part of British India. Zhob agency was formed in 1890 and Musakhel territory was annexed to it. Musakhel was made a tehsil in 1892 and was transferred to Loralai district in October 1903.
In 1905, the Musakhel tehsil comprised 61 villages and the total population, according to 1901 census, was 15,537 (8,374 males and 7,163 females). The principal tribes represented were: Isot Afghans (1,941); Jafar Afghans (1,026); Panri Afghans (10,144) including the Musakhel clan (9,748) the principal divisions of which were the Belkhel (7,662) and Laharzai (2,086); and Saiads (271). The chief language spoken was Pushto.Musakhel remained a tehsil of Loralai district till 1st January 1992 when it was notified as a district as a result of splitting Loralai district into 3 districts, Loralai, Musakhel, and Barkhan. Although Musakhel is an old human settlement there is no remarkable archaeological site.