Sometime in 1918, there was an army station hospital in the US Army Reservation that was then occupying a large portion of the present Legazpi-Daraga boundary area.  This hospital building a 2-storey "barracks” type structure was  donated by the US government to the Provincial Government of Albay, whereby it became the Provincial Hospital.  It was headed by Dr. Shannon Richmond who was at the same time the District Health Officer.  The Albay Provincial Hospital was the first government hospital in the whole region.

The promulgation of Commonwealth Act and Amendment Act No. 2168 in 1927 started the Albay Provincial Hospital in a better course towards serving the medical needs of the province.  The act authorized the construction of a three-storey concrete building, which was to house 50 beds and the doctor’s office and dispensary.  The main     building was inaugurated in May 27, 1928.  The Old wooden building was converted into a nurse’s home.

In 1942, Japanese soldiers made the hospital building for their quarters.  The patients and the personnel were displaced and they were accommodated temporarily at the Milwaukee Hospital building, a mission hospital, in Old Albay.  A few months later, hospital operations were transferred to a relatively big two-storey wooden building in a site now occupied by the Bicol College in Daraga town.  During the Battle of Liberation in September 1944, this temporary hospital and the Japanese occupied Albay Provincial Hospital were both destroyed in the carpet bombing and conflagration.  For a few months after this all hospital operations ceased.

A Philippine Civilian Authority Unit (PCAU) hospital was established with the help of Dr. Damaceno J. Ago in April 1, 1945.  The PCAU hospital was financed by the US Army substituted for the still suspended operations of the post-liberation Albay Provincial Hospital.  The hospital resumed operations later in the same year up to the early part of 1950 in a building at the corner of Rizal and Balagtas St., in Old Albay District.

Renovation of the damaged building was completed by year 1950.  The hospital resumed full operations.  Several annex buildings were constructed: a nurse’s home, the Chief of Hospital quarters and quarters for the Administrative Officer – the only one still existing.  All were wooden chalet-type building.

In October 21, 1952, Typhoon Trix wrought havoc over most of the Bicol Region and the hospital buildings were not spared.  From this time on, after renovating the destroyed hospital buildings, series of buildings were constructed:  these were the nurse’s homes and dispensary annex, the doctor’s quarters, the boy’s quarters, the kitchen and the maternity and children’s building.

In 1970, the hospital bed capacity was increased from 50 to 75.  In February 1973, under Department Order NO. 94-A, the Albay Provincial Hospital was designated as a training and teaching hospital.

Early in 1975, the official bed capacity of the hospital was increased from 75 to 150.  The total personnel complement has also increased.  Then in 1991, it was again increased to 250 but personnel complement and financial resources were not augmented.

In 1984, the Albay Provincial Hospital was integrated to the Albay Provincial Health Office where the Field Health Services was merged under a separate division with the Hospital Services.  The name of Albay Provincial Hospital took a sideline as it was now called Albay Provincial Health Office.

With the passage of R.A. 7160, otherwise known as the Local Government Code of the Philippines, the Albay Provincial Health Office was devolved to the provincial government of Albay.  With four other agencies devolved to the local government, the share of the hospital from the total cost of devolved functions drastically reduced its funding.  During the time it was devolved, no acquisition of equipment was made nor was there infrastructure funds released to the hospital.

Republic Act 8051 in 1994 provided the relief that the hospital was looking for.  It converted the hospital services of the Albay Provincial Health Office to the national government and  upgrade it  into a  tertiary  regional  training  and  teaching hospital to be called Bicol Regional Training and Teaching Hospital.  It became a reality in July 1997 when funds in General Appropriations Act included the operation of the hospital.

Due to its national funding, the hospital acquired new equipment, upgrades its services and boosted the morale of the employees to cope up with the challenge of its new mandate – a training and teaching hospital.  Additional personnel of 158 were added.  Two new buildings were constructed in 1997-2000 - the OB and Pedia Building and the OPD complex.  For years 2001-2003, various repairs and renovations were undertaken.  Foremost of which is Medical Building and OR building which is the hospital counterpart in the Netherlands Grant for medical Equipment. The ER Complex was also renovated and in the same area is the CT Scan Room which funding for the equipment was donated by the Philippine Charity Sweepstakes Office.  The OPD Complex though is half finished due to lack of funding but the finished areas are being utilized for OPD and Pharmacy Services.  Various equipment was also acquired to provide new services as well as replace old ones.