The Salford and Pendleton Dispensary was founded in 1827 in response to a growing need for relief of the sick poor in Salford. The hospital catered for home patients, out patients and accidents, but there were no in-patients. With the support and advice of the MRI, a number of staff were appointed. Of these, the surgeon John Boutflower served the hospital for sixty two years, and was made consultant surgeon in 1870. From the beginning, the dispensary saw large numbers of patients, including many who had suffered accidents working in the local industries. The dispensary expanded rapidly and, thanks to good financial control, within four years a new and adequately sized building was built. The dispensary was run on donations and subscriptions. Only patients who were too poor to pay were eligible for treatment, and these, except emergency cases, needed to be referred to the dispensary by a subscriber. This system was not without its problems, as the area did not have a large number of wealthy inhabitants, and those who grew wealthy often left the area. Despite such problems, the need for such an institution in Salford was evident, and expansion continued. The original premises of the dispensary consisted of a converted shop and adjacent building. The new dispensary building at the junction of Chapel Street and Adelphi Street was opened in 1831. It included rooms which would later be used as wards, but at the time the dispensary still did not admit in-patients. When King William IV became the first royal patron the institution was renamed the Salford and Pendelton Royal Dispensary. In 1845, the Dispensary admitted its first in-patients, and in 1847 the name was changed to the Salford and Pendleton Royal Hospital and Dispensary. Further developments included an extension of two new wings in 1865 and the large Pendlebury extension opened in 1887, funded by a legacy from John Pendlebury. Such expansions and various reorganisations took the number of beds from 16 in 1845 to 260 by 1913.
By the 1870s, the hospital had changed its name to Salford Royal Hospital, but was often referred to as Salford Infirmary. In 1873, local people in Pendleton requested a local branch dispensary, as the Chapel Street site was a long way to walk to. The Pendleton Branch Dispensary was founded in 1875 in New Street, Pendleton, and was administered by Salford Royal Hospital. By 1911 the branch had closed as it had become difficult to find honorary staff. This was compounded by the building of a new out-patient department at Salford Royal Hospital. Around 1890, Salford Royal Hospital was recognised as a training institution for medical students by the Victoria University of Manchester. The Hospital was also active in the training of nurses, being registered as a recognised training school by the General Nursing Council in 1923. During and after the First World War, Salford Royal Hospital grew in size and expertise. A number of specialist clinics were formed, including the Orthopaedic Department under Robert Ollerenshaw, the Genito-Urinary Department and the Venereal Disease Centre. Many honorary staff of Salford Royal Hospital were important figures in medicine; they include John Dixon Mann (also Professor of Forensic Medicine at Manchester University), Garnett Wright, J.B. Macalpine, and Geoffrey Jefferson, neurosurgeon. During World War Two, the nurses home was destroyed by an air raid, killing a number of nurses and trainees. With the advent of the NHS in 1948, the Salford Royal Hospital ceased to be a voluntary hospital and became part of the Salford Hospitals Group. Enlargements and reorganisations continued into the 1960s and 1970s, with a new outpatients department and a fracture clinic. The Hospital closed in 1993 when Hope Hospital enlarged and became the Salford Royal Hospital Trust.