During the Gulf War in 1990, it was the first Army hospital unit established and deployed into Iraq with combat forces of the XVIII Airborne Corps.

[2] It was activated the following month in the Army of the United States as the 28th Portable Surgical Hospital based at Fort George G. Meade, Maryland.

Upon reactivation, the 28th was stationed at Fort Bragg, North Carolina, and was brought up to operational status, fielding the Medical Unit, Self-contained, Transportable (MUST) system, which replaced the equipment sets that the Surgical Hospitals had previously been using.

They also deployed to St. Thomas, in the United States Virgin Islands, in October 1995 to support the Hurricane Marilyn relief operations.

In October 2009, the 28th Combat Support Hospital deployed in support of Operation Iraqi Freedom where it operated medical treatment facilities in several different locations around the country providing health care to service members, DOD civilians, US contractors, third country nationals, Iraqi civilians, and many others.

The 28th CSH continued to serve during Operation New Dawn and redeployed back to Ft. Bragg, North Carolina in October 2010 after 12 months of service.

CLINOPS incorporated MTOE Assigned Personnel (MAPs) integration into the CSH, validated the FBNC Pre-hospitalization plan; executed the Capability Development Integration Directorate (CDID) proof of concept: 4-bed (FST w/ ICU) and further build to 10-bed w/ EMT+ PLX, eventually complexing a 44- bed hospital in under 72 hours, and conducted the second ever cadaver lab in the CSH footprint; which trained over 60 medical procedures needed to meet ICTLs.

The 430th MED DET and the 131 MED DET will have the mission: deploy to augment the Field Hospital (32 BED) with operational dental care, and provision of one additional ICU ward, one ICW ward, additional microbiology capabilities and outpatient services for all classes of patients within a theater of operations.

[12] The 28th Combat Support Hospital is currently attached to the 44th Medical Brigade and is based at Fort Bragg in North Carolina.

[2][Note 1] The DEPMEDS system consists of "canvas tents that are connected to hard-sided boxes" which, when fully established, requires an area of 25 acres (100,000 m2),[14] and provides a suite of medical facilities and support equipment that allows the unit to perform a large number of functions similar to that of more permanent facilities including pharmacology, radiology and surgery.

[2] At the same time it maintains the ability to detach sub-units to task force level operations to provide front-line medical and surgical support.

[2][14] However, when not deployed it consists only of a small cadre staff who undertake various administrative tasks to keep the unit operational, while the majority of its medical personnel are stationed elsewhere at permanent facilities where they can use their training on a daily basis.

The unit possesses its own command, management and administrative support elements and consists of the following sub-units: A silver color metal and epoxied device 1 3/16 inches (3.02 cm) in width overall consisting of a maroon Greek cross superimposed by a silver stylized Chinese dragon, all surmounting and above a blue scroll the ends of the scroll terminating at the upper ends of the cross and inscribed “SERVICE THROUGH MOBILITY” in silver letters[16] Maroon and white are the colors used for the Army Medical Department.