The University of Texas Medical Branch is turning 135, and League City sits at the center of a $300 million expansion of its hospital campus.

UTMB opened Oct. 5, 1891, in Galveston with 23 students and 13 faculty members. It now spans four campuses, six hospitals and more than 16,000 people, according to a university anniversary feature published Monday. The League City hospital campus at 2240 Interstate 45 is the focal point of the expansion the University of Texas System Board of Regents approved in February.

The multiphase project will more than double emergency capacity, replacing the current 17-bed emergency room with a new 40-bed Emergency Department, first reported by The Galveston County Daily News. The existing ER will become a 20-bed observation unit for patients who need short-term monitoring. A new 20-bed medical-surgical unit, expanded diagnostic imaging with MRI, CT, ultrasound and fluoroscopy, and enlarged pharmacy and laboratory space are also part of the plan.

Services will open as each phase wraps up. The full project is expected to be finished by 2030.

The campus handles about 42,370 emergency visits a year across 97 beds. League City's population reached an estimated 118,456 as of July 2024, up from 114,392 in 2020, according to U.S. Census Bureau figures.

UT System Chancellor John M. Zerwas said in February that the regents backed the project because of UTMB's regional role. "The regents and I are very proud of the extraordinary role UTMB plays in offering world-class health care to the coastal communities," Zerwas said.

UTMB first opened outpatient clinics at the League City site in 2010, two years after Hurricane Ike flooded much of the Galveston campus and forced the system to rethink where it delivered care. The hospital opened in 2016 as League City's first, according to a UTMB magazine feature. A five-story patient tower and 60 new beds followed in 2020.

Beyond the League City project, UTMB announced in August a combined $180 million commitment from the Sealy & Smith Foundation to expand cardiovascular care, research and education. The foundation paired a $50 million gift made in 2025 with an additional $130 million, creating the largest philanthropic investment in university history, as reported by the Houston Chronicle. The foundation has given more than $1.2 billion to UTMB since 1922.

UTMB President Jochen Reiser, who has led the institution since 2023, said in the university's Monday anniversary feature that the milestone carries an obligation to keep building on what earlier generations started. He pointed to the League City expansion, new cardiovascular programs and the use of artificial intelligence as examples of that forward push.

No date has been announced for a groundbreaking ceremony or phase-one opening of the $300 million expansion.