The Metropolitan Free Hospital was founded by Joseph Fry, the son of Elizabeth Fry.  It opened in 1836 at 29 Carey Street, Stepney, to offer treatment to those 'whose only recommendations are poverty, destitution and disease'.  The Governors of the Hospital were mostly businessmen in the City of London.  Only out-patients could be seen at the Hospital because of financial constraints (even the rent for the premises was sometimes in arrears).

On 23rd May 1843 the Duke of Cambridge visited the Hospital and proposed that six beds should be made available for in-patients. This was achieved by 19th June the following year.

In 1850 the Hospital moved to 8 Devonshire Square.  Again, financial considerations meant that only out-patients could be treated, but on 20th August 1850 two rooms were converted into a 2-bedded ward to reassure the public that in-patients would be admitted when funds would allow.

The building, however, was needed by the Great Eastern Railway Company for the extension of Liverpool Street station and, after long negotiations, was sold to them in February 1876 for £8,500.  The Hospital had already closed on 21st December 1875 while it moved to a former warehouse at 81 Commercial Street in Spitalfields.  The Out-Patients Department reopened on 3rd January 1876 and the wards four months later in April.

It was planned to erect a purpose-built Hospital in Half Moon Street and Bishopsgate Street, but the project was delayed as sitting tenants had to be removed from the site.  By the time this had been achieved, it emerged that the Great Eastern Railway Company also needed this site for Liverpool Street station and the Great Eastern Hotel.  The Hospital Governors sold it to them for £25,000 in 1882.

A suitable place for a new Hospital was found in 1883 on the corner of Kingsland Road and St Peter's Road (renamed St Peter's Way in 1936) and the 1.64 acre site was bought for £5,896.  Building work began, but delays occurred.  The lease for the Commercial Street building expired in 1885 before the new Hospital was completed and  in-patients had to be sent home or transferred to other hospitals.  A cottage and some shops at the corner of Kingsland Road and Enfield Road were rented on a weekly basis for out-patients, but this arrangement was not satisfactory and, in August 1885, the Governors insisted that the Out-Patients Department be completed in two weeks.  Despite this, the Department finally opened on 29th September.  The remainder of the Hospital was completed in the autumn of 1886, when it had 160 beds.

Because of the difficulties of obtaining and keeping senior nursing staff, the post of Matron was often vacant.  The Governors overcame this by inviting the co-operation of the Order of All Saints, an Anglican nursing order, who then provided nursing staff from 1888 to 1895 (in 1862 the Order had taken over responsibility for nursing at University College Hospital).  The Sisters wore the regulation costume of the Order - a blue and white striped linen dress, a large white apron and a white frilled cap.

Intended to serve a poor area, the Hospital suffered from a lack of funds from subscribers.  The Governors decided that the financial situation would only improve if subscribers contributed on a regular basis, whether ill or not.  The word 'Free' was removed from the title and it became simply the Metropolitan Hospital.  However, out-patients attending between 09.00 and 12.00 and between 19.30 and 20.30 received free medical advice from the doctor on duty and free medicine for seven days from the Hospital's provident dispensary.

In 1893 the Hospital was bequeathed £10,500 by Mr Henry Spicer on the grounds only the interest of the money be used, and that exclusively for Samaritan purposes, for example, for a convalescent home.  Since it did not have such a home, the Governors decided to ask the Cornish philanthropist John Passmore Edwards if he would provide one.  He agreed to this and a site was eventually found at Cranbrook, Kent (the Home opened in July 1897 - see below).

By 1896 two 6-bedded wards on the ground floor were reserved for Jewish patients; a Jewish physician had been appointed on the staff.  A kosher kitchen with its own cook was located in the basement.   The general kitchen was also in the basement, as were the rooms for vegetables and milk, the larder, the Home Sister's room and the Servants' Hall, etc.

During 1899 some 867 in-patients and 101,597 out-patients received treatment but, by 1900, despite an increase in subscriptions, the Hospital was only able to open 72 of its 160 beds because of financial restraints.

In 1902 King Edward VII became the Hospital's patron but although the financial situation improved, problems continued and, by 1904, only 111 beds were available.

In 1909 the Hospital closed for alterations and renovations.  The Casualty Department was relocated to the basement, where the Electrical Department, the Chapel and a Billiard Room for resident staff were also to be found.  The old Casualty Department, just to the right of the front door, was converted into a Board Room, while the old Board Room on the first floor became a sitting room for the resident staff.  A passenger lift was installed in the centre of the staircase.  

The interior was painted in soft blue 'Paripan' paint, a washable lacquer-enamel believed to last four to five times as long as normal paint.  The wards were painted green, except for the children's ward, which was tiled; child-sized sanitary fittings were installed in the bathroom.  The installation of wash basins on the wards, with hot and cold running water, replaced the constant filling of the 'doctors' jugs' and their consequent emptying into the 'doctors' basins'.  The ward kitchen ranges, rarely used, were replaced with gas rings.

The theatre on the top floor was considerably improved and re-equipped.  An anaesthetic room was also provided.  The cubicles of the ward on the top floor were painted white.  This ward was not used for patients but served as sleeping accommodation for nurses until a Nurses' Home could be built.

The Out-Patients Department, where more than 44,000 patients were seen annually, was reconstructed.  The former Waiting Hall was made into a Central Hall, with consulting rooms leading off it.  A small operating theatre was also installed.

The Hospital was officially reopened on 20th December 1909 by the Lord Mayor, accompanied by the Lady Mayoress and the Sheriffs of the City of London.

During WW1 the Hospital became a section of Queen Alexandra's Military Hospital in Millbank.  It provided 302 beds for wounded and sick officers.

In 1920 the Hospital received £11,000 from the King's Fund, which enabled it to reduce its debt of £30,000.  Fund-raising activities began in August, with a 'Lest We Forget' carnival and procession through northeast London, in order to raise £50,000 to improve the Casualty Department and to build a desperately needed Nurses' Home (the various buildings used for staff quarters were in a bad state of disrepair and infested with rats, mice and other vermin).  In 1921, following a carnival, 2 tons and 8 cwt (5,376 lb/2,440 kilos) of copper coins were collected from 1,900 collecting boxes.

On 11th March 1927 the Queen laid the foundation stone for a Nurses' Home to be built at the corner of Enfield Road and St Peter's Road at a cost of over £60,000.

During 1934 some 1,981 in-patients and 29,313 out-patients were treated, most from the Hackney area.  Special departments had been established in ENT and gynaecology, as well as a tuberculosis dispensary.

In 1948 the Hospital joined the NHS under the control of the Central Group Hospital Management Committee, part of the North East Metropolitan Regional Hospital Board.  In 1966 its administration was transferred to the new East London Committee, when it was linked with St Leonard's Hospital in Shoreditch.  Its
Casualty Department closed when the new Accident and Emergency Department opened at St Leonard's Hospital.

In 1974, following a major reorganisation of the NHS, the Hospital came under the auspices of the City and Hackney (Teaching) District Health Authority, part of the North East Thames Regional Health Authority.

The Hospital closed in 1977 with 146 beds.