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Oregon State Hospital is located in what is referred to as the Oregon State Hospital Historic District, and was registered with the National Register for Historic Places in 2008.
The original Oregon Hospital for the Insane was established by J. Hawthorne in what was then East Portland, Oregon, (now the Hawthorne District).
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A narrow gauge railroad was established on the grounds of the hospital during its construction, leading into different tunnels and buildings.
These tunnels allowed the hospital to move patients between buildings without the public observing and are marked by purple-colored The tunnels connect different buildings of the State Hospital together.
A number of the bamboo railroad cars were converted to non-rail cars by removing the railroad wheels and adding casters; one of these cars is displayed in the Oregon State Hospital Mental Health Museum.
In addition to the narrow gauge railroad, a standard gauge railroad spur from the Southern Pacific's Geer Branch extended north from the penitentiary to the State Hospital.