Abstract: Asakayama General Hospital has a long history since 1922. The project is the landscape design of approximately 9,000m2 site including the first floor landscape area, the third floor rooftop rehabilitation garden, and the fourth floor palliative care garden. The hospital consists of the new general department with 223 beds, and also the existing department of psychiatry with 840 beds and welfare facilities across the street. It was originally built in 1922 by cutting through the hill called Kaorigaoka, but the area currently surrounding the hospital is residential. The white tower is designated as an important cultural property in Sakai City, and the lush greenery on site acts as a landscape icon that reminds people of the hill in the old days. The project intends to pass down the history of the hospital to the next generations. The goals are to increase sustainability as an essential hospital to the community, to keep providing the medical care, to create an attractive and good place to work for the staff, and to be accepted by the community by improving the environment.