The hospital was designed by John Lamb Murray to accommodate 500 patients and opened as the Lanark District Asylum in 1895.

[1][2]: 38  The complex included staff-houses, gardens, a farm, a power-plant, a reservoir, a railway-line and a cemetery.

[2]: 32  Two large separate blocks were added in 1898, a tuberculosis sanatorium was completed in 1906 and a nurses' home was opened in 1931.

[1] Although briefly used by Lanarkshire Television as a film studio, the Hartwood Hospital buildings subsequently fell into disuse.

[4] In February 2020 it was reported that portions of Matt Reeves's The Batman were being filmed at the location, with the site dressed as Gotham Orphanage.