When built in 1878, "it held the top spot among public building in Puerto Rico," based on its size and beauty.

Construction started on 30 May 1873,[5] it was delivered to the Municipal government by the Spanish Royal Corps of Engineers in September 1876,[6] and opened to the public on 11 December 1878.

[10] Just 7 years after its opening, by 1885, the hospital had been such a success there was no longer enough room for the growing population of the city of Ponce, so an annex was started.

The main alteration to the structure was the addition of a new emergency entrance on the southern side on the Bertoly Street facade.

"[12] In 1972 the Municipality adopted a resolution to rebuild the hospital but, after additional consideration, the plan was abandoned in 1974 in favor of building a new facility away from congestion and with sufficient space for parking.

[16] The oldest records found indicate that the structure was built in 1885 consisting of a one-story building organized around two identical anterior courtyards.

In contrast, the first floor of this south facade presents large rectangular windows with wide planar moldings and a simple cornice with a segmental pyramidal profile on the top molding, a cornice and rectangular windows with false segmental arch crowned by an equally false keystone all part of the original 1885 construction.

[16] The rear half of the building conserves the original one-story configuration with a repetition of rectangular openings surrounded by wide planar moldings and top cornices.

Crowning the center bay of the north (Calle Arenas) facade there is a simple triangular pediment with the date "1885" on top.

The bottom of this rear part is lifted on a podium and the pilasters are surmounted by an entablure with a very simple frieze and architrave.

This addition does not contribute to the property's architectural value but due to its disposition and volume it does not harm the main structure's integrity either.