The fort was active from 1878 to 1944; the cantonment is currently home to a Veterans Health Administration hospital and South Dakota Army National Guard training facilities.

Fort Meade was established in 1878 to protect illegal white settlements on the Great Sioux Reservation in the northern Black Hills, especially the nearby gold mining area around Deadwood.

In the Fort Laramie Treaty of 1868, the Black Hills of South Dakota were set aside for the use of the Lakota people as part of the Great Sioux Reservation.

However, the discovery of gold in the region in the 1870s prompted numerous whites to illegally enter the reservation; these trespassers demanded protection from the United States Army.

During the occupation of this camp, the present site of Fort Meade, situated just outside the eastern foothills of the Black Hills, and on the south side of Bear Butte Creek, was selected and located as a permanent United States military post, which was established and garrisoned on August 31, 1878.

[2] Like the previous military installations on the site, Fort Meade functioned as an important command center for the United States during the Indian Wars and the expansion of pioneer Americans into the area.

This culminated in the Ghost Dance War and Wounded Knee Massacre of 1890 at the Pine Ridge Indian Reservation, in which the Seventh Cavalry stationed at Fort Meade, led by Colonel Forsyth, participated.

In 1892, the post commander Colonel Caleb H. Carlton, 8th Cavalry, began the custom of playing the "Star Spangled Banner" at military ceremonies and requested that all people rise and pay it proper respect long before it became the national anthem.

[5] By 1910, however, the American West had fully outgrown the fort's original purposes, and instead it began functioning more as a training ground and to develop mechanized cavalry units.

The dedication was held on April 6, 1945, and was attended by Charles Windolph, the last surviving United States Army soldier at the Battle of the Little Bighorn, as the guest of honor.

[5] The VA decided, despite the renovations, that the long-term goal would be to construct entirely new, modern-style buildings, and hired on the Saint Paul, Minnesota-based Ellerbe & Company architectural firm to design a new complex.

The VA also began selling off unused parts of the large acreage to various buyers, including the City of Sturgis and the Bureau of Land Management; by the 1970s, the complex reached its current size of about 250 acres (100 ha).

The VA also dismantled unused structures and sold the materials and made improvements to the main hospital wing, including automatic doors and heated sidewalks.

[2] In 1891, several Native American troops were recruited by the United States Army, with the intention to foster peaceful relations between the tribes and the white settlers.

Pending the war, the Eighth Cavalry Regiment, which had occupied the post for ten years, was broken up and scattered, the last troops leaving on October 6, 1898, for Huntsville, Alabama, from where they were to be sent to join the army of occupation in Cuba.

The garrison, in October 1898, consisted of two troops of the First United States Cavalry, transferred there from the battlefields of San Juan Hill and El Caney.

[3] After the Fourth Cavalry was deployed to Europe during World War II, a branch of the Women's Army Corps and the 620th Engineer General Service Company were garrisoned there briefly until about 1942.

Since its establishment, the fort has at different times included a sawmill; schoolhouse; library; hospital; cemetery; bakery; granary; barracks and other lodgings; cavalry stables; guardhouses; recreation hall; swimming pool; firing and training grounds; and other assorted offices, storage, and support buildings.