John Munro, President of the Incorporation of Surgeons in 1712, set in motion a project to establish a "Seminary of Medical Education" in Edinburgh, of which a General Hospital was an integral part.

[7] His son, Alexander Monro primus, by then Professor of Anatomy, circulated an anonymous pamphlet in 1721 on the necessity and advantage of erecting a hospital for the sick and poor.

In 1725, the Royal College of Physicians of Edinburgh wrote to the stock-holders of the Fishery Company, which was about to be wound up, suggesting that they assign their shares for the purpose of such a hospital.

Other donors included many wealthy citizens, most of the physicians and several surgeons, numerous Church of Scotland parishes (at the urging of their Assembly) and the Episcopal meeting houses in Edinburgh.

[9] A "gentlewoman" was engaged as Mistress or House-keeper, and a "Nurse or Servant" was hired for the patients, both women to be resident and "free of the burden of children and the care of a separate family."

Diseases cured included pains, inflammations, agues, ulcers, cancers, palsies, flux, consumption, hysterick disorders and melancholy.

A free advice and medicine service for out-patients was very popular, receiving a 1,000 patients by 1754,[11] which presented the hospital with prohibitively high costs and demand.

Fundraising began for a new hospital, driven by Monro and Drummond, and the appeal attracted funds from churches throughout Scotland, landed gentry, private individuals, and prominent professionals including physicians, surgeons, merchants and lawyers, as well as donations of labour and building materials.

[13] In 1750, Scottish surgeon Archibald Kerr left a slave plantation he owned in Jamaica, Red Hill Pen, to the Royal Infirmary of Edinburgh in his will.

Kerr also left the 39 slaves which were kept as forced labourers on the plantation to the infirmary, which owned Red Hill Pen from 1750 to 1893 (with slavery being abolished in Jamaica in 1833).

According to the BBC, the infirmary used the wealth generated from Red Hill Pen to "buy medicines, construct a new building, employ staff, and heal Edinburgh's "sick poor"."

In 2023, the health board of NHS Lothian publicly announced that they would be providing reparations for slavery after discovering the Royal Infirmary of Edinburgh's ownership of the plantation.

This was soon found to be inadequate and a new surgical hospital, designed by David Bryce, was built fronting Drummond Street, opening in 1853.

[21] In 1879, at the instruction of the then Lord Provost, Thomas Jamieson Boyd,[22] the infirmary moved to a new location, then in the fresher air of the edge of the city.

By 1932, the school's new premises in Colinton Road were ready, and the old Archibald Place building was demolished to make way for the Simpson Memorial Pavilion, used primarily as a maternity wing.

[27] In May 2001, Lothian Health Trust sold the 20-acre (81,000 m2) Lauriston Place site for £30 million to Southside Capital Ltd., a consortium comprising Taylor Woodrow, Kilmartin Property Group, and the Bank of Scotland.

[34] Furthermore, the economic consultants Jim and Margaret Cuthbert unveiled evidence in the Scottish Left Review outlining why the PFI scheme was a poor use of public funds whilst resulting in huge profits for private investors.