Pierce Griffyth, Agent of the Sick and Wounded Board, oversaw construction of the hospital under the orders of Admiral Sir John Jennings.

The island continued to be used as a hospital, as well as occasionally as a warehouse for coal and naval stores by the Spanish, French, British, Italian, and American navies through the 19th and 20th centuries.

[6] In 2004, the Fundación Hospital de la Isla del Rey was established with the aim of restoring and maintaining the facilities.

The foundation succeeded in restoring the exterior of the main building in 2011, the 300th anniversary of the hospital, and continues to the improve facilities and provide access to the island to tourism.

[5] Hauser & Wirth leased part of the islet from the foundation to create a 16,000 square foot art center, following a conservation project overseen by Luis Laplace,[7] repurposing existing historic buildings,[8] and with gardens designed by Piet Oudolf.