New York City mayor John Francis Hylan's original plans for the Independent Subway System (IND), proposed in 1922, included building over 100 miles (160 km) of new lines and taking over nearly 100 miles (160 km) of existing lines.

[6][7] On December 9, 1924, the New York City Board of Transportation (BOT) gave preliminary approval for the construction of the IND Eighth Avenue Line.

[5]: 8  Squire J. Vickers, the chief architect of the Dual System, helped design the 181st Street station.

[5]: 9 In December 1950, the New York City Board of Transportation issued a report concerning the construction of bomb shelters in the subway system in the midst of the Cold War.

To become suitable as shelters, the stations would require water-supply facilities, first-aid rooms, and additional bathrooms.

[24] The 181st Street station is mostly unchanged from its original design, although it has deteriorated over time, with some water damage.

On September 5, 1957, the New York City Transit Authority (NYCTA) began allowing free public access to the elevators at the 181st and 190th Street stations.

Bills were proposed in the New York State Legislature to put the elevators out of fare control, but these failed in committee.

[30] The attendants at the five stations are primarily maintenance and cleaning workers who suffered injuries that made it hard for them to continue doing their original jobs.

As part of the plan, all elevator operators at 181st Street, along with those in four other stations in Washington Heights, would have been cut.

[37][38] MTA employees had joined riders in worrying about an increase in crime as a result of the cuts after an elevator operator at 181st Street on the Broadway–Seventh Avenue Line helped save a stabbed passenger.

However, on December 7, 2007, the MTA announced that it would not remove the remaining elevator operators at these stations, due to pushback from elected officials and residents from the area.

[40] In October 2018, the MTA once again proposed removing the elevator operators at the five stations, but this was reversed after dissent from the Transport Workers' Union.

[5]: 3 The outer walls of the platform level consist of tiled alcoves, slightly recessed within concrete arches.

[5]: 4 A pedestrian concourse is located above the platforms along the station's entire length, supported from the cemented barrel-vaulted ceiling by steel Y-shaped struts.

This concourse connects the two mezzanines at the north and south ends of the station and has four steel-and-concrete stairs to each platform.

[5]: 5 [64] This entrance is accessed from a single-story head house with a stepped roof and a facade of stone and ashlar.

A backlit, Art Deco "Subway" sign is located above and in between the archways, atop a stone pedestal.

[5]: 5 The entrance on Fort Washington Avenue between 183rd and 185th Streets leads to three elevators that descend 100 feet (30 m) to mezzanine level.

[5]: 5 [64] It is entered from a single-story stone vestibule with a pointed diamond-shaped arch surrounded by an interlacing diamond motif.

[11]: 184  The vestibule leads to a slightly recessed masonry structure that rises two stories above the height of Fort Washington Avenue.

[5]: 6 The entrance at Fort Washington Avenue and 181st Street consists of four stairs, two to each southern corner of the intersection.

[68] Additional elevators were announced between the platforms and mezzanine in December 2019 as part of the agency's 2020–2024 Capital Program[69] and were completed in 2023, making the station ADA-accessible.

[55] Patrons with wheelchairs are able to traverse from this entrance to the passageway out to Overlook Terrace, as the elevators provide direct access to both the mezzanine and street level.

[72] On September 13, 1980, aspiring pianist Eric Kaminsky was robbed and stabbed to death in the station.