The Midland was designed by architect Thomas W. Lamb of New York and the Boller Brothers of Kansas City, and Boaz-Kiel Construction of St. Louis erected the structure.

The exterior of the theatre was constructed in a Renaissance Revival style in cream glazed terra cotta brick, adorned with engaged pilasters, winged figures, leaves, flowers, swags, volutes, urns, and arches.

The theater is well known for its over 500,000 feet of gold leaf, five giant Czechoslovakian hand-cut crystal chandeliers, irreplaceable art objects and precious antiques, and spectacular wood and plaster work.

After the organ changed hands and was moved across the country several more times, it was eventually purchased by local enthusiasts in 1984 and is now at home in the Kansas City Music Hall.

Among the major changes made in the redevelopment, the main-level seating rows were removed and replaced with a tiered open floor plan that allows for cabaret-style tables and chairs, or standing room for general admission events.

According to the Cordish Company of Baltimore, the developer of the project, all changes meet historic preservation guidelines as required by state and federal governments.