The hospital stood on a hill overlooking the Pacific Ocean and the Hunter River port of Newcastle, New South Wales, from 1817 until 2007.

The hospital grew in step with Newcastle from its founding as a penal settlement and coal port.

The hospital in turn had a powerful influence on the East End of central Newcastle and portside communities and on people's wellbeing throughout the Hunter Valley.

[1] During the mid to late twentieth century, under medical superintendent, Chris McCaffrey, the hospital became a centre for innovation in Australian healthcare, introducing reforms to nursing with Matron Hall and in specialist medical care and records keeping.

[3] By 2007, the year it closed, the Royal Newcastle was one of the oldest, largest and best-known hospitals in Australia.