In 1961, Rev J McConaghy established a Survey Committee to determine what community support could be obtained for a Presbyterian private hospital in Toowoomba.  Following a favourable response a Planning Committee was appointed during 1962.
In 1963 Mr and Mrs J Bain of Jandowae donated five acres of land for the building of the Hospital.  The following year they donated $184,000 (a considerable amount in 1964) as a memorial to their son James Douglas. A contract for building construction was signed in 1965 and the foundation stone was laid by Rev J McConaghy.
St Andrew’s Toowoomba Hospital commenced operation on 9th July 1966 as a 42-bed private hospital with two operating theatres.
In 1980, approval was granted for an extension to increase the hospital’s bed capacity to 62 beds. The Hospital was further extended in 1983 to 72 beds which incorporated a 3 bed high dependency unit.

1987 saw an extension of the theatre suite to accommodate four theatres. Work also commenced on a 30 bed extension to be completed and opened in 1988 to become North Wing. Administration and foyer areas were also enlarged during this particular scope of works.

A new kitchen, staff/conference facilities and coffee shop were part of a new wing opened in 1991.

Major redevelopment incorporating the Day Hospital, Storeroom, Engineering Services and increased parking spaces were completed and opened in 1993/94.

The Sleep Studies Unit was established in 1995 and a new state-of-the-art laundry facility commissioned in 1996.

In 1997 licensed bed capacity was increased to 111 beds and then to 129 beds in 1998 with the opening of the new East Wing and High Dependency Unit. Central Ward was refurbished during 1999.

2000 saw many changes to the hospital with the opening of the Mental Health Unit in the refurbished West Wing of the Hospital. A Diagnostic Breast Clinic was established and the High Dependency Unit was upgraded to an 8 bed Adult Intensive Care Unit bringing the total bed number to 131.

A Cardiac Rehabilitation Unit, Continence Clinic and the John Stedman Chemotherapy Unit were also opened in 2000.

In 2001 the hospital received a generous bequest from the late John and Beryl Macvean. It was agreed by the hospital and the trustees of the estate that the funds would be used to build a Cardiac Catheterisation Laboratory.
2002 saw the opening of the John and Beryl Macvean Cardiac Catheterisation Laboratory as well as the first private Renal Dialysis facility on the Darling Downs.
During 2003 construction of the Central Sterilising Supply Department was commissioned and the licensed bed capacity increased to 137 beds.
St Andrew’s Cancer Care Centre treated their first radiotherapy patient on 28 May 2007 thanks to a successful $8.6 million tender being awarded to the hospital through the Commonwealth Department of Health and Ageing. The John Stedman Unit was also co-located to the St Andrew’s Cancer Care Centre during June 2007.
St Andrew’s is committed to the community and its health needs. To this end the hospital is continually improving and upgrading facilities to ensure the highest level of care is available for its patients. 2008 saw the opening of the St Andrew’s Medical Centre and retail pharmacy.
During 2009 the Renal Dialysis unit was extended from 6 stations to 12 due to demand. Ophthalmology services were introduced at St Andrew’s with 2 Ophthalmologist setting up private practice on-site.
During 2011 Qld Health approved the extension of the existing Cancer Care Centre after the hospital was awarded $6.7m from the Commonwealth Government during April 2010 to expand cancer services.
In 2012 two ENT Surgeons commenced private practice on-site along with the Neurosensory Unit. The hospital applied for 4 paediatric licensed beds and was successful. As part of the cancer service expansions the John Stedman Unit (oncology services) expanded form 15 chairs to 25 chairs.
2013 has seen Radiation Oncology Queensland expand from two linear accelerators to three along with the John Stedman Medical Oncology Unit expanding from 15 chairs to 25 chairs thanks to assistance from the Commonwealth Department of Health and Ageing. The hospital will also redevelop the Mental Health ward of the hospital which is expected to open late 2013.
2014 The Hospital purchased a da Vinci Surgical System robot – the first for a regional hospital in Australia at a cost of $2.6 million

2015 The new six-bed cardiac monitoring unit opens in January, followed by the opening in February of an EndoAlpha 3D image-capable operating theatre (known as ‘Theatre 6’ or the ‘Blue Theatre’), which is the first to be installed in a hospital in the Southern Hemisphere. In October the Hospital opens its seventh operating theatre, also known as the ‘Hybrid Theatre’.
The Recovery Ward area is doubled in size, and work commences to increase carparking capacity by 120 spaces. PET/CT Scanner was installed by Qld X-Ray.

During 2016 St Andrew’s Toowoomba Hospital celebrated its 50th Birthday, we saw the launch of Blush Week, the prostate cancer specialist nursing program commenced, car parking spaces increased to 683 (an additional 115). The hospital invested in a $1.5 million generator upgrade to support the hospital’s complex medical and surgical services as well as support future expansion.
2017 has seen the introduction of reconstructive bowel surgery, the first gynaecology robotic assisted surgery. Echocardiograms were introduced, the Radiation Oncology department installed the world’s most innovative Haycyon system and St Andrew’s was the first hospital in Australia to purchase the latest Olympus 4K Surgical System. During June we lost one of Toowoomba’s greats, Mr Treg Rowe who served on the hospital Board as Chairman for 45 years.
In 2018 the hospital commenced building works for South Ward (new Mental Health building), theatres 1 and 2 were upgraded and a Rapid Access Heart Centre (level 3 emergency department) was introduced. The hospital purchased and cleared 3 house blocks for future car parking and built a number of medical suites.

2019 saw the new 20 bed South Ward opened in March for mental health patients a MDT meeting Room was built for doctors and allied health professionals to meet and discuss complex cases and the houses on 1 and 3 Pioneer Street were demolished to make way for more car parking.