The hospital has its origins in a facility built in Old Blackrock Road close to present site of the South Infirmary in 1791.

[1] The facility joined the state system as a "district asylum", as defined in the Lunacy (Ireland) Act 1821, in 1845.

[1][2] In the late 1840s, a site in Shanakiel was identified for the construction of new hospital of sufficient size to meet the increasing requirements of the City.

[2] The new hospital, which was designed by William Atkins in the Gothic revival style and built by Alex Dean, was named after the Earl of Eglington, the Lord Lieutenant of Ireland.

[2] An annex, which subsequently became known as St. Kevin's Hospital, was built to the east of the main structure in the late 1890s.