Built in 1856 to isolate and treat people with smallpox, the hospital was part of New York’s effort to control a disease that repeatedly swept through the city. The building later became a nursing school. As vaccination transformed public health and smallpox was eradicated, the building lost its purpose and was eventually abandoned.
The disease is gone. The building remains.
Jenner inoculates eight-year-old James Phipps with cowpox. Two months later, Phipps is exposed to smallpox and does not become ill.

Jenner performing his first smallpox vaccination on a child in 1796, Science History Images
New York City begins a program of smallpox vaccination. The vaccine offers a way to prevent the disease, but outbreaks continue.
New York City purchases Blackwell's Island for $32,000 and begins developing it as a site for institutions, including hospitals and prisons.
New York Public Library
The island · Minnahanonck to Roosevelt
A penitentiary, an asylum, an almshouse, and hospitals for contagious disease — and, since 1969, a residential neighborhood with a tram, a subway stop, and Four Freedoms Park. The ruin stands at its southern end.
A large unvaccinated population leaves New York vulnerable to recurring outbreaks. In 1850, smallpox accounts for 25.4 of every 1,000 deaths in the city. A New York State report describes the city's smallpox facilities as “a pile of poor wooden outhouses on the banks of the river.”
New York begins construction of a permanent smallpox hospital on Blackwell's Island, designed by James Renwick Jr. The hospital is the first major U.S. hospital built specifically for the treatment and isolation of people with smallpox. Prisoners on the island quarry, cut, dress, and lay the stone.
Library of Congress
The architect · 1818—1895
Renwick was engaged to design the cathedral in 1853, one year before ground was broken here. Grace Church, the Smithsonian Institution Building, the Corcoran Gallery, and Vassar were his as well.
The hospital is completed on December 18 at a cost of approximately $38,000. Its location, separated from Manhattan by the East River, allows the city to isolate people with smallpox from the rest of the population.
The wooden buildings previously used for smallpox patients are destroyed by fire. Patients move into the new stone hospital on January 3.
The Board of Health assumes control of the hospital and renames it Riverside Hospital. Its patients now include people with diseases other than smallpox.
Riverside Hospital closes and its patients move to North Brother Island. The stone building is stripped and rebuilt as the Home for Nurses of Maternity and Charity Hospital Training School.
Renwick dies on June 23. He is buried at Green-Wood Cemetery in Brooklyn.
New wings add classrooms, dormitories, and training wards. The south wing is designed by York & Sawyer and completed in 1904. The north wing, designed by Renwick, Aspinwall & Owen, follows in 1905.
In Jacobson v. Massachusetts, the U.S. Supreme Court upholds the authority of states to require smallpox vaccination to protect public health.
The city renames Blackwell's Island Welfare Island.
A traveler arrives in Manhattan carrying smallpox. Twelve people become ill and two die. The city vaccinates approximately 6.35 million people in less than a month.
The United States records its last naturally occurring case of smallpox.
The nursing school moves elsewhere and the building is abandoned. The city begins depositing landfill south of the hospital. Over the next three decades, the island grows by approximately five acres.
The World Health Assembly adopts a resolution calling for the worldwide eradication of smallpox.
Water enters through the roof. Plaster falls, windows break, and vegetation takes hold. The Landmarks Preservation Commission identifies the building among the island structures worthy of preservation.
The World Health Organization launches its Intensified Smallpox Eradication Programme under Donald A. Henderson. The campaign expands vaccination, case finding, outbreak response, and international cooperation.
New York State hires architect Giorgio Cavaglieri to stabilize seven historic structures on the island. The Smallpox Hospital's roof is removed around 1971, leaving the stone shell open to the sky.
The Smallpox Hospital is listed on the National Register of Historic Places.

New Yorkers waiting to receive their free smallpox vaccinations outside Morrisania Hospital, Ossie Leviness
The island is renamed Roosevelt Island in honor of Franklin D. Roosevelt.
Rahima Banu, a three-year-old girl in Bangladesh, becomes the last person known to contract variola major, the more severe form of smallpox. She survives.
The Landmarks Preservation Commission designates the Smallpox Hospital a New York City Landmark.

Historic American Buildings Survey
Ali Maow Maalin, a hospital cook in Somalia, becomes the last person known to contract naturally occurring smallpox. He survives.
Janet Parker, a medical photographer in Birmingham, England, dies after exposure to smallpox virus in a laboratory accident. She is the last known person to die from smallpox.
Smallpox is declared eradicated. The World Health Assembly makes the declaration on May 8, 1980.
The ruin enters the New York State Register. The same year, the Smallpox Hospital is entered on the State Register of Historic Places.
Friends of Roosevelt Island Landmarks installs floodlights to illuminate the ruin.
A winter storm causes a large section of the north wall to collapse. Emergency shoring and bracing are installed.
New York State Parks supports a structural survey by Walter B. Melvin Architects to assess the condition of the ruin.
A new pandemic fills hospitals across New York City. Healthcare workers confront a disease for which there is no established treatment or vaccine.
The Smallpox Hospital remains fenced off and closed to the public.
Research for this timeline included the Roosevelt Island Historical Society, the Roosevelt Island Operating Corporation, the New York Public Library, the New York City Municipal Archives, the Library of Congress, and the World Health Organization.