The synagogue provides pastoral care, adult education, a conversion class, activities for children and families and is the location for important Jewish communal services and events.

The foundation stone was laid on the 26th of January 1875 by Saul Samuel, Postmaster General, the first Jewish minister of the Crown in the British Empire.

Other notable firms connected with the work were William Coleman (carpentry and joinery), Fletcher Brothers (decorative cast iron), Lewis and Steel (decorative plaster), Cornelius and Co of Philadelphia (gas fixtures), Minton Hollins & Co (tiles), P. N. Russell & Co (cast iron columns), and Lyon & Cottier (stained and etched glass).

[11] In 1988 the Bicentennial Council of NSW recognised the importance of the building and recommended a significant grant for restoration work on the Elizabeth Street façade.

[12] Rather, the architect the then popular Romanesque decorative elements with Gothic arches, adding a few subtle hints of Moorish décor inside the Synagogue.

The Elizabeth Street frontage and towers are of Pyrmont stone, and the remainder of the early structure is brick with cast-iron columns and timber floors, and a slate roof.

The interior is decorated with moulded plaster, carved timber and stained glass, all embellished with abstract patterns to avoid representation of living forms.

The basement contains a hall which has steel portal frames supporting the columns and floor above, and also contains the AM Rosenblum Museum and Rabbi Falk Library.

The contemporary addition, constructed of reinforced concrete, contains offices, classrooms & meeting rooms, together with a lift & fire stairs, and has a top floor with an openable roof.

The building contains examples of venerable sacred scrolls and religious artefacts, including a menorah (nine-branched candelabrum) made by Rabbi L. A.

He was assisted by the Second Minister of the congregation, Reverend Aaron Alexander Levi (1823-1883), who had previously led the York Street Synagogue in 1860–61,[16] following the resignation of Rev Morrice Robertson Cohen.

Cohen died in office in 1934 and was succeeded briefly by Rabbi Ephraim Moses Levy from 1935 to 1938, who came from the Durban United Hebrew Congregation.

From 1973 to 2005 Rabbi Raymond Apple led the congregation and made several changes to the synagogue, including introducing the priestly blessing on festivals, instituting a male choir and enabling the first individual bat mitzvah on a Shabbat morning.

The cantor from 1964 to 1989 was Rev Isidor Gluck, who guided the service towards a less English and more Eastern European style, while maintaining its cantorial and choral nature.

Rabbi Elton is also the Orthodox Rabbinic Consultant to the Executive Council of Australian Jewry and the New South Wales Jewish Board of Deputies.