He came to London with his father in 1691, and matriculated at Balliol College, Oxford, 8 July 1699, graduating B.A.

He does not appear to have practised medicine, at least in London, till middle life, since it was not till 9 July 1722 that he took the degree of M.D.,and six years later, 23 December 1728, was admitted candidate of the College of Physicians of London, succeeding to the fellowship 22 December 1729.

He was elected physician to Bethlehem Hospital for lunatics 9 October 1728, which appointment he held till his death.

His policy in not admitting students or physicians to the practice of his hospital was the subject of hostile criticism in Dr. Battle's treatise on 'Madness' (London, 1758, 4to), and was defended in a pamphlet by his son John Monro, who is separately noticed.

James Monro's only literary production was the Harveian oration at the College of Physicians in 1737.