The Ponte Fabricio, the only original bridge in Rome, connects the island from the northeast to the Field of Mars in the rione Sant'Angelo (left bank).

Another version of the legend says that the people gathered up the wheat and grain of their despised ruler and threw it into the Tiber, where it eventually became the foundation of the island.

Upon consulting the Sibyl, the Roman Senate was instructed to build a temple to Aesculapius, the Greek god of healing, and sent a delegation to Epidauros to obtain a statue of the deity.

Travertine facing was added in mid or late first century by the banks to resemble a ship's prow and stern, and an obelisk was erected in the middle, symbolizing the vessel's mast.

After the Temple of Aesculapius, shrines dedicated to other deities were also erected after the 2nd century BC, namely:[3] In time, the obelisk was removed and replaced with a cross-topped column.

This monument, designed by Ignazio Jacometti, is decorated with statues of four saints related to the island: St. Bartholomew the Apostle, St. Paulinus of Nola, St. Francis of Assisi and St. John of God.

In 998 Emperor Otto III had a basilica, that of San Bartolomeo all'Isola, built over the Aesculapius temple's ruins on the eastern side (downstream end) of the island.

In the early 20th century, prior to the Fascist regime's restoration of ancient place names, the Tiber Island was called the Isola di S.