Introduced in 2001, MDX was named North American Truck of the Year by a group of 50 independent automotive journalists. Improvements for 2002 brought an even quieter ride.

For 2003, Acura has further refined MDX, with significant upgrades to the engine, driveline, body, suspension, and steering. Acura's "Next Generation" V6 boosts horsepower from 240 to 260 and reduces emissions while maintaining the same EPA-rated fuel economy. An all-new, more compact five-speed automatic transmission shifts even more smoothly than before. A new drive-by-wire throttle helps reduce shift shock and incorporates cruise control functions. And MDX's standard VTM-4 four-wheel drive system has been remapped to work seamlessly with a new Vehicle Stability Assist (VSA) system to improve performance on low-traction surfaces, and to enhance stability in all conditions.