It is the southernmost member of the State University of New York (SUNY) system and the only academic medical center for health education, research, and patient care serving Brooklyn's 2.5 million residents.

In 2010 SUNY Downstate celebrated its sesquicentennial, commemorating the year that the Long Island College Hospital (as it was then known) first opened its doors to students.

Yet Downstate traces its roots back even further (to 1856) when a small group of physicians set up a free dispensary in Brooklyn to care for poor immigrants.

The first faculty included many distinguished physicians, such as Dr. Austin Flint Sr., remembered for his role in introducing the stethoscope into standard medical practice in this country.

The “Downstate” era began on April 5, 1950, with the signing of a merger contract between the State University of New York (SUNY) and the Long Island College of Medicine.

In 1987 Governor Mario Cuomo and Mayor Edward Koch helped break ground for the new Health Science Education Building, where most student classes now take place.

HEAT[6] is a program established and directed by Dr. Jeffrey Birnbaum which offers culturally competent care for youth who are living at high risk of developing HIV/AIDS.

The clinic hosts an annual conference on health seen through the eyes of medicine, art, technology and community called BFC What's Next.

[citation needed] SUNY Downstate is an important research facility where scientists and clinicians explore many urgent health problems.

In FY 2011, sponsored research programs, including those funded by the National Institutes of Health (NIH), DARPA, and private foundations, totaled over $60 million.

The audit cited bloated salaries for top administrators, underuse and poor financial decisions contributed to the losses.

[12][13] In January 2020, two SUNY Downstate surgeons filed lawsuits accusing the medical center of retaliation against them for reporting patient safety and death concerns in the heart-surgery and organ-transplant programs.