Roper St. Francis Healthcare has begun construction on its new Roper Hospital campus in North Charleston, a $1.2 billion project set to expand the health system’s regional footprint and replace its downtown Charleston facility.

The future hospital will occupy a 27-acre site. This marks the fourth location for Roper Hospital since it was founded in 1856 and aligns with the organization’s 2030 strategic plan to improve access to care across the Lowcountry.

“This is the next chapter of a nearly 2-century-old story,” said Joseph DeLeon, president and CEO of Roper St. Francis Healthcare.

The campus will include a full-service emergency department equipped for trauma and critical care; multiple operating rooms, including hybrid suites; and a medical office building for outpatient and specialty services. Other features include patient-centered inpatient units, enhanced security systems, and a greenbelt connecting buildings.

Roper St. Francis leaders said the facility’s design was heavily influenced by clinicians. More than 550 hours were spent by nurses, physicians and other staff participating in design sessions using full-scale mockups and virtual simulations.

Charles Fletcher, vice president of construction, real estate and support services, called the groundbreaking “the culmination of years of planning” and input from clinical teams and partners.

Architecture firms E4H Environments for Health Architecture and Skidmore, Owings & Merrill are leading design, with Barton Malow Builders and Edifice Construction managing the build. Roper St. Francis Foundation also launched a $100 million campaign to support the project through 2030.

The health system, based in Charleston, South Carolina, emphasized it will continue to serve downtown Charleston residents and is evaluating future plans for that area.

North Charleston Mayor Reggie Burgess described the hospital as “a symbol of progress, hope and commitment to our community.”

Completion is expected in 2029