Partly developed in the 1860s with large terraced houses on a steeply sloping open hillside, the crescent—which "curves and changes height dramatically along its length"—was finished two decades later and now forms the centrepiece of the Round Hill conservation area.

The five original sets of houses from the 1860s have been listed at Grade II by English Heritage for their architectural and historical importance, and the crescent occupies a prominent place on Brighton's skyline.

Brighton was originally a fishing village on the English Channel coast, with the chalk hills of the South Downs rising immediately behind.

Topped with a windmill since 1838, the only other development until the 1860s consisted of a few middle-class villas and the horseshoe-shaped Park Crescent at the bottom of the southern slope.

[7] The opening of the railway led to the rapid construction of lower-class housing in the surrounding area, but the example set by Park Crescent encouraged developers to continue to introduce higher-quality, larger-scale residential schemes.

[9] The arable land of the higher parts of the hill, mostly owned by Thomas Read Kemp and the Stanford family, was released for development in the 1860s.

[14] The gaps were filled in between 1880 and 1885 when smaller terraced houses, mostly of two storeys and featuring the canted bay windows and decorative mouldings characteristic of Brighton's Victorian residential architecture,[13] were built.

She moved the dispensary to Roundhill Crescent and opened a 12-bed hospital alongside it, for the treatment of women and children with mental health problems.

[17] The conventional practice at the time was to send sufferers of mental health problems to lunatic asylums rather than offer medical care.

[10] Roundhill Crescent forms a "majestic sweep" on the steep, visually prominent hillside, which can be seen from many parts of north and east Brighton.

[23] The non-listed houses on the northwest side are mostly of the same height but lack many of the features shared by the listed buildings, in particular the "highly decorative" balconies.

The insertion of modern exterior features such as replacement doors, windows and roofs has been restricted by an Article Four Direction, covering the whole Round Hill conservation area, since 2000.